Oral Atypical Cellular Blue Nevus: An Infiltrative Melanocytic Proliferation

Abstract

The atypical cellular blue nevus is an extremely rare nevomelanocytic lesion which lacks precise histologic characterization in the current literature. Given the potential for significant architectural and cytologic overlap with melanoma, further study, including molecular analysis, is needed. This is the first description of an atypical cellular blue nevus of the oral cavity.

Blue Nevus of the Hard Palate: The Importance of a Careful Examination in an Emergency Setting

“…Its 5-year survival rate ranges from 10–45% [ 7 ]. Malignant transformation or recurrence of a blue nevus, though extremely rare, can in fact develop [ 2 , 7 , 16 , 21 ]; most often, if not always, its stated that it occurs in cellular types, although this is still subject to debate [ 2 , 3 , 6 , 7 , 11 , 15 ].…”

“…Its 5-year survival rate ranges from 10-45% [7]. Malignant transformation or recurrence of a blue nevus, though extremely rare, can in fact develop [2,7,16,21]; most often, if not always, its stated that it occurs in cellular types, although this is still subject to debate [2,3,6,7,11,15]. Some oncogenic protein mutations have been described in common nevi and in both cutaneous and oral melanoma; the most consensual finding is a mutation in Bioinformatics Resources and Applications Facility (BRAF).…”

“…Because of multiple reports of tumors with features combined between CBN and OMM, the controversial designation of “atypical blue nevus” or “atypical cellular blue nevus” was created for these borderline lesions [ 8 , 10 , 14 , 15 ]. However, despite the efforts, there is still no uniform histological criteria to differentiate atypical CBN from OMM [ 14 , 16 ].…”

Atypical Cellular Blue Nevus of the Foot: A Case Report

“…It is a rare variant of cellular BN, with clinical features resembling classic BN and histological features similar to malignant BN [4]. Compared to common BN, ACBN often shows asymmetry on histology, an infiltrating border, and extension into subcutaneous tissue [6]. The lesion exhibits sheet-like growth.…”

“…However, there is usually a pattern of nesting in the tumoral area that may be highlighted with the use of a reticulin stain. Furthermore, it has a higher proliferative index and higher mitotic rate [1, 6]. Because of the presence of atypical spindle cells with periadnexal or perineural infiltration and peri- or intratumoral lymphocytic infiltrates, ACBN can be misdiagnosed as malignant melanoma.…”