Malignant melanoma of the mandibular gingiva

A malignant melanoma is a highly lethal melanocytic neoplasm. A neoplasm usually affects the skin. Malignant melanomas in the head and neck region are rare, accounting for less than 1% of all melanomas. Malignant melanoma of the nose and paranasal sinuses is an aggressive disease typically presenting at an advanced stage, with a 5-year survival rate ranging 20-30%. Melanomas are tumors arising from melanocytes, which are neuroectodermally derived cells located in the basal layers of the skin. This is a case report of a 35-year-old male, who presented with very aggressive disease and developed liver metastasis.

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“…The cells and the corresponding neoplasms arising from the neural crest are grouped under dispersed neuroendocrine system (DNES) tumors. [ 5 ]…”

Section: Introductionmentioning

confidence: 99%

Malignant melanoma maxilla

Devi

Sinha

Singh

2015

Natl J Maxillofac Surg

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“…[ 18 19 ] There are very few reported cases of malignant melanoma on the mandibular gingiva. [ 20 – 22 ] Our patient is one of those rare cases, as the site of occurrence of the lesion is the mandibular gingiva.…”

Section: Discussionmentioning

confidence: 99%

Oral malignant melanoma: A silent killer?

Padhye¹,

D'souza²

2011

J Indian Soc Periodontol

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Oral malignant melanomas are extremely rare lesions and occur commonly in the maxillary gingiva more frequently on the palate with fewer incidences in the mandibular gingiva. Though these lesions are biologically aggressive, they often go unnoticed since they are clinically asymptomatic in the early stages and usually present merely as a hyperpigmented patch on the gingival surface. These lesions if diagnosed at an early in situ stage are potentially curable and definitely have a better prognosis, but unfortunately as they are clinically asymptomatic, it results in delayed diagnosis thus making the prognosis extremely poor. This paper presents the case of a patient who visited our department with the complaint of darkened patches on the gums and his concern was purely aesthetic. There were no symptoms associated with the hyperpigmented lesions and hence the patient did not approach us earlier. When the lesions grew larger and were unsightly, the patient has seeked dental advice. Histopathologic investigation confirmed the diagnosis as ‘Oral Malignant Melanoma’. Though aggressive therapy was instilled immediately, unfortunately, the patient succumbed to death within a few months after diagnosis as the lesion was highly invasive. Due to the biologically aggressive but clinically silent nature of progression of the lesion, the importance of maintaining a high index of suspicion and early detection and diagnosis for any pigmented gingival lesions cannot be overemphasised. Diagnosis must be based on thorough detailed history and valid histologic evidence.

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“…8 Clinical differential diagnoses include Kaposi's sarcoma, nevi and giant cell epulis. 9 Prompt biopsy and histopathological examination of the lesion are confirmatory. Determining whether a mucosal melanoma is a primary or metastatic lesion is important because cutaneous melanoma may metastasize to the mucous membranes.…”

Section: Discussionmentioning

confidence: 99%

Primary Malignant Melanoma of the Gingiva: A Case Report and Review of Literature

Singhal¹,

Mohan²,

Lehl³

et al. 2011

JIAOMR

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Mucosal melanoma of the head and neck is a relatively rare condition that has been poorly understood, characterized and studied.A 28-year-old male patient reported a swelling in relation to the right upper incisor teeth. The lesion was mobile, with slight bleeding on probing. Differential diagnosis of gingival hyperplasia/fibrosis, giant cell epulis, Kaposi's sarcoma, and malignant melanoma were kept. Histopathological sections showed sheets of pleomorphic spindle cells with intracytoplasmic brown-black pigment, involving the lower part of the squamous epithelium. Tumor cells were positive for S-100 and HMB-45 (Human Melanoma Black) immunostain and a diagnosis of malignant melanoma was rendered. The patient underwent partial maxillectomy and the case was categorized as stage II. He also received regional radiotherapy; however after five months, the patient presented with a metastasis to the lymph nodes that was confirmed on fine needle aspiration cytology (FNAC). The patient underwent radical neck dissection that showed a large tumor mass.In contrast to cutaneous melanoma, the mucosal melanomas have an aggressive vertical growth phase. Different cell types, like spindled, plasmacytoid, and epithelioid may be observed. The treatment of choice is complete excision with adequate negative margins. The role of radiotherapy is not clearly defined since malignant melanoma is relatively insensitive to radiation. The prognosis for mucosal melanoma is generally quite poor because of its tendency to invade and cause early hematogenous metastasis. Nodal involvement reduces survival time and multiple local recurrences are the most common cause of treatment failure.

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Malignant melanoma of the mandibular gingiva

Cited by 3 publications

References 13 publications

Malignant melanoma maxilla

Malignant melanoma maxilla

Oral malignant melanoma: A silent killer?

Primary Malignant Melanoma of the Gingiva: A Case Report and Review of Literature

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