Oral malignant melanoma: long-term follow up in three patients

Malignant melanoma of the mandibular gingiva

Oral malignant melanoma is an infrequent neoplasia making up less than 1% of all melanomas, which exhibits much more aggressive behavior than those found on the skin. We present an aggressive case of oral malignant melanoma located on the mandibular gingiva in a 24-year-old male patient, who developed metastases to not only the regional lymph nodes but also the lungs and liver. The advanced stage of the disease contraindicated any surgical intervention and palliative chemotherapy was planned.

Malignant melanoma of lingual gingiva with ipsilateral submandibular lymph node metastasis: a case report

Malignant melanoma is a neoplasm of epidermal melanocytes. It is one of the most biologically unpredictable and deadly of all human neoplasms. However, malignant melanoma in the oral cavity is a rare malignancy, accounting for 0.2% to 8% of all melanomas. It has a grave prognosis, with a 5 year survival of 10-20%. We present a case of malignant melanoma of lingual gingiva of left mandibular molars with ipsilateral submandibular lymph node metastasis. We performed peripheral osteotomy of primary lesion followed by modified radical neck dissection by sparing internal jugular vein and patient had received postoperative radiotherapy.

Primary oral mucosal melanoma: a series of 35 new cases from South America

Oral mucosal melanoma is rare and reported to be more aggressive than its cutaneous counterpart. Due to the rarity of this entity, data on epidemiology, tumor behavior, treatment, follow-up, and survival of patients are mainly based on single case reports. The few existing series of patients show that oral mucosa melanoma has its peak between 41 and 60 years of age, and male to female ratio is 2:1. Preferred oral sites include hard palate and maxillary alveolar crests. Risk factors have not been clearly identified, and surgical treatment is still the treatment of choice for oral mucosal melanomas. The authors retrospectively studied 35 patients with primary melanoma of the oral cavity to report their clinical and pathological features, such as age, sex, site of the tumor, metastasis, treatment, response to therapy, and outcome. We found no significant sex predominance, and the mean age of the patients was 60.6 years, with a range from 9 to 91 years. The majority of the patients (71.42%) had palate commitment, and invasive histopathological aspect was observed in 80% of the specimens (grade 3). Long-distance metastasis was found in 60% of the cases. Fourteen patients were submitted to wide surgical resections, with local relapse being observed in 11 of them (78.5%). The authors suggest that improved outcome in oral malignant melanoma requires the development of new therapies and the prevention of distant metastasis.

Primary malignant melanoma of the oral cavity: assessment of outcome from the clinical records of 35 patients

Oral malignant melanoma is extremely rare and carries a poor prognosis. The treatment of choice remains controversial. We retrospectively studied 35 patients with primary malignant melanoma of the oral cavity between 1970 and 2001 to define the clinical features of this disease and evaluate treatment methods. The main variables studied were clinical findings, response to therapy, and outcome. Surgery with complete macroscopic resection was performed at the primary site in 13 patients (surgery group) and radiotherapy was done without surgery in 17 (non-surgery group). The 5-year cumulative survival rate was 15.4% in the surgery group, 35.3% in the non-surgery group, and 21.8% overall. Distant metastasis was present in 64.7% (11/17) of the non-surgery group and 76.9% (10/13) of the surgery group. Improved outcome in oral malignant melanoma requires the development of new therapies and the prevention of distant metastasis.

[Melanoma of the hard palate]

Oral melanomas are extremely rare and occur most often on the palate and gingiva. Its prognosis is poor. Surgical management remains the preferred treatment, sometimes in combination with chemotherapy. We report the case of a 72 years old woman with a malignant melanoma of the hard palate who developed three years later a gingival nevi and 5 years later metastatic cervical lymph nodes. Our treatment has been only radical surgery all times.