1
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Şendişçi Gök R, Tercanlı H. A ten-year literature review of oral malignant melanoma cases: A meta-analysis study. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2024:101922. [PMID: 38795910 DOI: 10.1016/j.jormas.2024.101922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/22/2024] [Accepted: 05/22/2024] [Indexed: 05/28/2024]
Abstract
AIM Oral malignant melanoma (OMM) is a rare and aggressive malignant tumour arising from the proliferation of melanocytes and accounts for only 0.5 % of all oral malignancies. It is invasive and tends to metastasise. The aim of this study is to determine the patient profile of OMM and to provide information about the clinical features and treatment plans of the disease. MATERIALS AND METHODS The Pubmed database was searched for OMM cases published as case reports in the last 10 years. The search was limited to English and open-access case reports. A total of 49 OMMs in 45 patients from 43 case reports were analyzed. In addition to the age, gender, smoking and alcohol consumption habits of the patients, data on the signs and symptoms of OMM, location of the lesion, imaging modalities used in diagnosis and treatment, lymph node involvement, presence of metastasis, survival time, and treatment modalities were recorded. RESULTS In OMM cases, 18 (40 %) of the patients were female, 27 (60 %) were male, and the mean age was 53.13 ± 16.09 years. The most common symptom was "swelling" (n = 23, 33.8 %) and the most common finding was "hyperpigmentation" (n = 40, 24.4 %). The most common site of OMM was the maxilla (n = 21, 46.7 %). According to the rate of use of imaging modalities in the cases, it was determined that "advanced imaging modalities" were mostly used (n = 24, 53.3 %). It was determined that 22.2 % (n = 10) of the patients died within the first 5 years. Combined treatment (n = 21, 46.5 %) were mostly applied to the patients. CONCLUSION OMM is more common in the maxilla, in males and in the fifth decade of life, and advanced imaging modalities are most commonly used to detect the disease. Because of its poor prognosis, knowing the patient profile and common clinical features of OMM will increase the clinical awareness of physicians.
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Affiliation(s)
- Rümeysa Şendişçi Gök
- Research asistant, Akdeniz University Faculty of Dentistry, Department of Oral and Maxillofacial Radiology, Antalya, Turkey.
| | - Hümeyra Tercanlı
- Associate professor, Akdeniz University Faculty of Dentistry, Department of Oral and Maxillofacial Radiology, Antalya, Turkey
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2
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Pandiar D, Ramani P, Krishnan RP, Sushanthi CL, Ramasubramanian A. Is cellularity alone sufficient to sub-grade malignant melanoma histologically as spindle cell/desmoplastic variant? Oral Oncol 2021; 121:105497. [PMID: 34418697 DOI: 10.1016/j.oraloncology.2021.105497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Accepted: 08/11/2021] [Indexed: 10/20/2022]
Affiliation(s)
- Deepak Pandiar
- Department of Oral Pathology and Microbiology, Saveetha Dental College and Hospitals, Chennai, Tamil Nadu, India
| | - Pratibha Ramani
- Department of Oral Pathology and Microbiology, Saveetha Dental College and Hospitals, Chennai, Tamil Nadu, India.
| | - Reshma Poothakulath Krishnan
- Department of Oral Pathology and Microbiology, Saveetha Dental College and Hospitals, Chennai, Tamil Nadu, India
| | - Casilda L Sushanthi
- Department of Oral Pathology and Microbiology, Saveetha Dental College and Hospitals, Chennai, Tamil Nadu, India
| | - Abilasha Ramasubramanian
- Department of Oral Pathology and Microbiology, Saveetha Dental College and Hospitals, Chennai, Tamil Nadu, India
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3
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Cho H, Kim B, Kim OS, Kim Y, Yang Y, Song J, Liu D, Jeon S, Kim O. Photochemical reaction to increase melanogenesis using Buddleja officinalis and blue light-emitting diode irradiation in B16F10. Photodiagnosis Photodyn Ther 2021; 35:102456. [PMID: 34311092 DOI: 10.1016/j.pdpdt.2021.102456] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 07/08/2021] [Accepted: 07/20/2021] [Indexed: 10/20/2022]
Abstract
Recently, the incidence of vitiligo has increased because of stresses induced by external environment. Ultraviolet (UV) light therapy is the most commonly used method of treating the disease; however, UV light therapy requires a long treatment period, and prolonged exposure to UV radiation has side effects. The purpose of the present study was to investigate the effects of natural products and LED irradiation (LED-IR) on the synthesis of melanin. It was not possible to effectively increase intracellular melanin production through individual applications of Buddleja officinalis (BO), which is a natural substance selected through screening, or blue light irradiation (Blue-IR). However, when used in combination, these two agents stimulated adenylyl cyclase (AC) and melanin production was induced in the stimulated cells via the CREB/MITF/TYR pathway. Furthermore, the combined treatment with BO and Blue-IR generated low levels of cellular reactive oxygen species (ROS) and induced p38 phosphorylation, which in turn activated MITF in ROS-stimulated synthetic melanocytes, resulting in the promotion of melanogenic pathways other than the CREB/MITF/TYR pathway. In addition, this treatment combination effected melanin transport. These results suggested that the combined therapies can be used to treat melanin-deficiency skin diseases such as vitiligo.
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Affiliation(s)
- Hyejoung Cho
- Department of Oral Pathology, School of Dentistry, Chonnam National University, Gwangju 61186, South Korea
| | - Byunggook Kim
- Department of Oral Medicine, School of Dentistry, Chonnam National University, Gwangju 61186, South Korea
| | - Ok-Su Kim
- Department of Periodontology, School of Dentistry, Chonnam National University, Gwangju 61186, South Korea
| | - Young Kim
- Department of Oral Pathology, School of Dentistry, Chonnam National University, Gwangju 61186, South Korea
| | - Ying Yang
- Department of Oral Pathology, School of Dentistry, Chonnam National University, Gwangju 61186, South Korea
| | - Jianan Song
- Department of Oral Pathology, School of Dentistry, Chonnam National University, Gwangju 61186, South Korea
| | - Danyang Liu
- Department of Oral Pathology, School of Dentistry, Chonnam National University, Gwangju 61186, South Korea
| | - Sangmi Jeon
- Department of Oral Pathology, School of Dentistry, Chonnam National University, Gwangju 61186, South Korea
| | - Okjoon Kim
- Department of Oral Pathology, School of Dentistry, Chonnam National University, Gwangju 61186, South Korea.
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4
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Ardila CM, Arce-Jaramillo JM, Álvarez-Martínez E. Primary retromolar malignant melanoma in a Latin American patient. J Int Med Res 2020; 48:300060520919245. [PMID: 32326786 PMCID: PMC7218476 DOI: 10.1177/0300060520919245] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Accepted: 03/05/2020] [Indexed: 11/17/2022] Open
Abstract
Primary malignant melanoma of the oral mucosa is rare and has scarcely been reported in patients from Latin America. The most frequently affected sites include the palate and gingiva of the maxilla. In this report, we describe primary malignant melanoma in a Latin American patient. A 3 × 3.5-cm black tumor was observed on the upper left retromolar area. The lesion exhibited a sessile base, irregular edges, soft consistency, and pain on palpation. Immunohistochemistry staining results were positive for S100 and HMB-45; the Ki-67 index was 20%. Contrast tomography of the skull, face, abdomen, and thorax, as well as ultrasound of the liver, did not reveal metastatic lesions. The patient underwent wide surgical excision of the lesion, followed by radiotherapy; he was subsequently rehabilitated with a somato prosthesis.
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5
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Astekar M, Choubey RR, Manjunatha BS, Gupta S. Oral malignant melanoma of alveolar ridge. BMJ Case Rep 2019; 12:e227456. [PMID: 31154344 PMCID: PMC6557535 DOI: 10.1136/bcr-2018-227456] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/11/2019] [Indexed: 01/03/2023] Open
Abstract
Malignancy of melanocytes, a pigment-producing cell, is referred as malignant melanoma (MM) which occur basically on skin and oral mucous membrane, but as well found in ears, eyes, gastrointestinal tract and genital mucosa. Oral melanomas has propensity to metastasise and invade more voluntarily than other malignant counterparts. Here we present a case of 52-year-old male patient with a chief symptom of blackening of gums in the upper front tooth region. In dental history, the patient revealed history of faulty artificial prosthesis fixed in the same region since 6 months. On the basis of a through clinical assessment, a provisional opinion of oral malignant melanoma, was prepared. On histopathological and immunohistochemical analysis with S-100 and homatropine methylbromide 45 the diagnosis of MM was confirmed.
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Affiliation(s)
- Madhusudan Astekar
- Department of Oral and Maxillofacial Pathology, Institute of Dental Sciences, Bareilly, Uttar Pradesh, India
| | - Rajkumar R Choubey
- Department of Oral and Maxillofacial Pathology, Institute of Dental Sciences, Bareilly, Uttar Pradesh, India
| | | | - Santosh Gupta
- Oral and Maxillofacial Pathology, Jaipur Dental College, Jaipur, Rajasthan, India
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6
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Astekar M, Choubey RR, Manjunatha BS, Gupta S. Oral malignant melanoma of alveolar ridge. BMJ Case Rep 2019. [PMID: 31154344 DOI: 10.1136/bcr-2018-227456.] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Malignancy of melanocytes, a pigment-producing cell, is referred as malignant melanoma (MM) which occur basically on skin and oral mucous membrane, but as well found in ears, eyes, gastrointestinal tract and genital mucosa. Oral melanomas has propensity to metastasise and invade more voluntarily than other malignant counterparts. Here we present a case of 52-year-old male patient with a chief symptom of blackening of gums in the upper front tooth region. In dental history, the patient revealed history of faulty artificial prosthesis fixed in the same region since 6 months. On the basis of a through clinical assessment, a provisional opinion of oral malignant melanoma, was prepared. On histopathological and immunohistochemical analysis with S-100 and homatropine methylbromide 45 the diagnosis of MM was confirmed.
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Affiliation(s)
- Madhusudan Astekar
- Department of Oral and Maxillofacial Pathology, Institute of Dental Sciences, Bareilly, Uttar Pradesh, India
| | - Rajkumar R Choubey
- Department of Oral and Maxillofacial Pathology, Institute of Dental Sciences, Bareilly, Uttar Pradesh, India
| | | | - Santosh Gupta
- Oral and Maxillofacial Pathology, Jaipur Dental College, Jaipur, Rajasthan, India
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7
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Min SK, Jeong JH, Ahn KM, Yoo CW, Park JY, Choi SW. Desmoplastic melanoma of the oral cavity: diagnostic pitfalls and clinical characteristics. J Korean Assoc Oral Maxillofac Surg 2018; 44:66-72. [PMID: 29732311 PMCID: PMC5932274 DOI: 10.5125/jkaoms.2018.44.2.66] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2017] [Revised: 10/20/2017] [Accepted: 11/07/2017] [Indexed: 11/29/2022] Open
Abstract
Objectives Desmoplastic melanoma of the oral cavity is an extremely rare condition that is often confused on initial diagnosis with non-melanotic benign lesion or spindle cell tumors. The purpose of this article was to raise awareness of the disease using a literature review. Materials and Methods We analyzed 19 desmoplastic melanoma cases reported in the literature and added our experience. Data on clinical, histopathology, treatment, and survival were retrieved and analyzed. Survival analysis was by the Kaplan-Meier method. Results Initial clinical and histopathological features were indistinctive, and a definite diagnosis of desmoplastic melanoma at initial assessment was possible in only 23.5% of cases. Among tests, immunohistochemical studies for S-100 and vimentin were all positive. The 5-year disease-free survival rate for oral desmoplastic melanoma was 0%, and the 5-year overall survival rate was 55.0%. Conclusion Oral desmoplastic melanoma has a high percentage of initial misdiagnosis and propensity for local recurrence. Thus, careful initial diagnosis and adequate surgery may result in improved overall survival.
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Affiliation(s)
- Seung-Ki Min
- Oral Oncology Clinic, Research Institute and Hospital, National Cancer Center, Goyang, Korea
| | - Joo Hee Jeong
- Oral Oncology Clinic, Research Institute and Hospital, National Cancer Center, Goyang, Korea
| | - Kang-Min Ahn
- Department of Oral and Maxillofacial Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Chong Woo Yoo
- Department of Pathology, Research Institute and Hospital, National Cancer Center, Goyang, Korea
| | - Joo Yong Park
- Oral Oncology Clinic, Research Institute and Hospital, National Cancer Center, Goyang, Korea
| | - Sung Weon Choi
- Oral Oncology Clinic, Research Institute and Hospital, National Cancer Center, Goyang, Korea
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8
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Chaudhry A, Saluja P, Manjunath M. Is focal melanotic lesion potentially malignant? A case report. J Taibah Univ Med Sci 2017; 13:195-200. [PMID: 31435323 PMCID: PMC6695080 DOI: 10.1016/j.jtumed.2017.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2017] [Revised: 09/30/2017] [Accepted: 10/03/2017] [Indexed: 11/29/2022] Open
Abstract
Malignant melanoma is a lesion of melanocytes that is commonly observed on cutaneous surfaces. In 35–50% of cases, it originates from a pigmented precursor. Although oral melanocytic pigmentation is very common, melanocytic malignancies such as melanoma, are rare. Oral melanoma may arise from pre-existing pigmentation, but definitive precursor lesions have not been identified. Common sites for oral melanoma are the maxillary gingiva and palate. We report a case of malignant melanoma that transformed from a long-standing, focal, pigmented lesion on the mandibular gingiva and vestibular mucosa, suggesting the potentially malignant nature of focal oral melanotic lesions.
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Affiliation(s)
- Astha Chaudhry
- Department of Oral Medicine and Radiology, Faculty of Dental Sciences, Shree Guru Gobind Singh Tricentenary University, Gurgaon, India
| | - Pulin Saluja
- Department of Oral and Maxillofacial Pathology, Faculty of Dental Sciences, Shree Guru Gobind Singh Tricentenary University, Budhera, Gurgaon, Haryana, India
| | - Muniraju Manjunath
- Department of Oral Medicine and Radiology, Vokkaligara Sangha Dental College and Hospital, Bangalore, India
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9
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Alves ISS, Berriel LGS, Alves RT, Pinto MB, Oliveira CFP, Cazzotto AC, Moura WV. Sinonasal Melanoma: A Case Report and Literature Review. Case Rep Oncol Med 2017; 2017:8201301. [PMID: 28255482 PMCID: PMC5306975 DOI: 10.1155/2017/8201301] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2016] [Revised: 01/02/2017] [Accepted: 01/10/2017] [Indexed: 12/22/2022] Open
Abstract
Purpose. Sinonasal malignant mucosal melanoma is a rare, aggressive tumour. Nasal obstruction and epistaxis are the most commonly reported symptoms, although symptomatology may develop late and be nonspecific, which tends to delay diagnosis, resulting in a poorer prognosis. Case Report. This report describes a 64-year-old male patient with nasal obstruction and epistaxis. Computed tomography of the facial sinuses revealed a large lesion in the right nasal cavity, with infiltration into the left cavity, ethmoidal cells, and erosion of the cribriform plate. Initial incisional biopsy revealed an undifferentiated carcinoma of the right maxillary sinus, staged as T4aN0M0. Induction chemotherapy was initiated with cisplatin and etoposide. Response to treatment was complete. The patient was then submitted to radiotherapy with concomitant cisplatin. Immunochemical analysis revealed positivity for vimentin, S100, and HMB-45 (human melanoma black 45), a result compatible with a diagnosis of malignant melanoma. Discussion. Due to the rarity of the tumour and the patient's complete response to chemotherapy and since no blackened lesion had been found at the previous exam, treatment was continued as planned. The patient remains healthy, with no metastasis or recurrence. He is currently being monitored by the clinical oncology team.
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Affiliation(s)
- I. S. S. Alves
- Hospital Universitário Cassiano Antônio de Moraes, Santos Dumont, ES, Brazil
| | - L. G. S. Berriel
- Hospital Santa Casa de Misericórdia de Vitória, Vitória, ES, Brazil
| | - R. T. Alves
- Hospital Santa Casa de Misericórdia de Vitória, Vitória, ES, Brazil
| | - M. B. Pinto
- Hospital Santa Casa de Misericórdia de Vitória, Vitória, ES, Brazil
| | | | - A. C. Cazzotto
- Hospital Santa Casa de Misericórdia de Vitória, Vitória, ES, Brazil
| | - W. V. Moura
- Hospital Santa Casa de Misericórdia de Vitória, Vitória, ES, Brazil
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10
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Hasan S, Jamdar SF, Jangra J, Al Beaiji SMAA. Oral malignant melanoma: An aggressive clinical entity - Report of a rare case with review of literature. J Int Soc Prev Community Dent 2016; 6:176-81. [PMID: 27114959 PMCID: PMC4820579 DOI: 10.4103/2231-0762.175145] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
Melanomais one of the most dreaded and aggressive neoplasms, being derived from epidermal melanocytes. The majority of melanomas are seen to involve the skin, and primary mucosal melanomas account for less than 1% of all melanomas. Oral malignant melanomas (OMM) are asymptomatic at the initial presentation, but later they become painful with growth and expansion. In the late stages, the patient may present with ulceration, bleeding, tooth mobility, paresthesia, ill-fitting prosthesis, and delayed healing of the extraction sockets. Diagnosis is often delayed due to asymptomatic clinical presentation, with silent progression of the lesion. OMM are associated with poor prognosis due to their invasive and metastasizing tendencies. The condition has poor survival rates, and metastatic melanomas show even worse prognosis. The 5-year survival rate for OMM ranges 4.5–29%, with 18.5 months being the mean survival rate. The tumor is best managed by wide surgical resection; however, consideration should also be made for adjunctive therapies such as chemotherapy, immunotherapy, and radiotherapy. Recurrences may be seen even 10–15 years after the primary therapy. This paper aims to present an interesting report of aggressive OMM in a 50-year-old male patient and emphasizes the role of dental professionals in maintaining a high degree of vigilance for the pigmented lesions of the oral cavity. Pigmented lesions of uncertain origin should be routinely biopsied to rule out malignancy. Early diagnosis of this dreadful entity entails thorough history taking, physical examination, and radiographic features coupled with histopathology.
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Affiliation(s)
- Shamimul Hasan
- Department of Oral Medicine and Radiology, Jamia Millia Islamia, New Delhi, India
| | - Sami Faisal Jamdar
- Department of Oral and Maxillofacial Surgery, Teerthankar Mahaveer Dental College, Teerthanker Mahaveer University, Moradabad, Uttar Pradesh, India
| | - Jogender Jangra
- Department of Oral and Maxillofacial Surgery, Government Dental College, Post Graduate Institute of Medical Sciences, Pandit Bhagwat Dayal Sharma University of Health Sciences, Rohtak, Haryana, India
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11
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Martinelli-Kläy CP, Laporte ML, Martinelli CR, Martinelli C, Lombardi T. Oral Malignant Melanoma Initially Misdiagnosed as a Racial Pigmentation: A Case Report. Dermatopathology (Basel) 2016; 3:1-7. [PMID: 27195264 PMCID: PMC4868936 DOI: 10.1159/000444049] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Oral malignant melanoma (OMM) is rare, representing less than 0.5% of all oral malignancies. The most affected sites are the palate and the maxillary gingiva. Histological examination is important to establish the diagnosis of any suspicious pigmented lesion in the oral cavity, mainly if a precise clinical diagnosis is not possible. We present one case of OMM that was initially diagnosed as a racial pigmentation elsewhere 2 years earlier. Clinical examination showed multiple macules and nodules located on the hard and soft palate, gingiva and superior alveolar mucosa. These lesions were painless and presented a color variation going from dark blue to black. Histological analysis showed sheets and nests of atypical melanocytes displaying a range of shapes such as plasmacytoid, epithelioid, and round cells, located in the superficial corium extending to the deep tissues. A few tumor cells contained variable amounts of melanin. There was no invasion of blood vessels or nerve fibers. Immunohistochemical analysis revealed that the neoplastic cells were positive for HMB-45, melan-A, S-100 and negative for AE1/AE3, confirming the diagnosis of melanoma. The Ki-67 labeling index was around 25%. The patient refused any treatment and died 11 months later.
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Affiliation(s)
- Carla Patrícia Martinelli-Kläy
- Oral Medicine and Oral Maxillofacial Pathology Unit, Division of Oral Maxillofacial Surgery, Department of Surgery, Geneva University Hospitals and Faculty of Geneva, Geneva, Switzerland; Centre for Diagnosis and Treatment of Oral Diseases, Ribeirão Preto, Brazil
| | - Marcel Leandro Laporte
- Oral Medicine and Oral Maxillofacial Pathology Unit, Division of Oral Maxillofacial Surgery, Department of Surgery, Geneva University Hospitals and Faculty of Geneva, Geneva, Switzerland
| | | | - Celso Martinelli
- Centre for Diagnosis and Treatment of Oral Diseases, Ribeirão Preto, Brazil
| | - Tommaso Lombardi
- Oral Medicine and Oral Maxillofacial Pathology Unit, Division of Oral Maxillofacial Surgery, Department of Surgery, Geneva University Hospitals and Faculty of Geneva, Geneva, Switzerland
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12
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Abstract
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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Affiliation(s)
- Seema Devi
- Department of Radiation Oncology, Indira Gandhi Institute of Medical Sciences, Patna, Bihar India
| | - Richi Sinha
- Department of Radiation Oncology, Indira Gandhi Institute of Medical Sciences, Patna, Bihar India
| | - Rakesh Kumar Singh
- Department of Radiation Oncology, Indira Gandhi Institute of Medical Sciences, Patna, Bihar India
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13
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Gupta S, Tandon A, Ram H, Gupta OP. Oral malignant melanoma: Report of three cases with literature review. Natl J Maxillofac Surg 2015; 6:103-9. [PMID: 26668465 PMCID: PMC4668719 DOI: 10.4103/0975-5950.168239] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
Primary oral melanoma is known to be an extremely rare and aggressive neoplasm arising from the mucosal epithelium of the oral cavity especially upper jaw (palate or alveolar gingivae). Malignant melanoma that does not originate in the skin is a very rare disease and is considered one of the most deadly of all human neoplasms. Oral malignant melanoma (OMM) represents about 1% of all melanomas and approximately 0.5% of all oral malignancies. OMM has been reported in patients aged 20 to 80 years and has a male predilection. Because most mucosal melanotic lesions are painless in their early stages, so delayed recognition and subsequent treatment result in worst prognosis. Here, we report three cases with significant heterogeneity in morphological features and biologic behavior.
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Affiliation(s)
- Shalini Gupta
- Department of Oral Pathology, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Ankita Tandon
- Department of Oral Pathology, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Hari Ram
- Department of Oral Surgery, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - O P Gupta
- Department of General Surgery, Carrier Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
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14
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Ohnishi Y, Watanabe M, Fujii T, Sunada N, Yoshimoto H, Kubo H, Wato M, Kakudo K. A rare case of amelanotic malignant melanoma in the oral region: Clinical investigation and immunohistochemical study. Oncol Lett 2015; 10:3761-3764. [PMID: 26788204 DOI: 10.3892/ol.2015.3819] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2014] [Accepted: 06/22/2015] [Indexed: 01/28/2023] Open
Abstract
Amelanotic malignant melanoma (AMM) is rare in the oral region. The present study examined the clinical features of this tumor in an attempt to establish diagnostic criteria. The expression of three melanocytic differentiation markers, HMB-45, S-100 and Melan-A, was also measured in primary oral AMMs in order to determine whether the markers could be used to diagnose primary oral AMMs and to find out which marker was the most sensitive. It may be particularly difficult to correctly diagnose AMM that lacks a radial growth phase without immunohistochemical assistance. In the present study, mixtures of polygonal and spindle cells at different ratios were observed in the tumors with and without a radial growth phase. Immunohistochemistry was used to examine the HMB-45, S-100 and Melan-A expression in the formalin-fixed paraffin-embedded specimens of primary oral AMMs. Comparison of staining intensities (SIs) and labeling indices (LIs) of the markers was also performed. The immunostaining results revealed that the SI of Melan-A was significantly higher than that of S-100 (P=0.0011). HMB-45, S-100 and Melan-A also exhibited high positive rates and LIs in AMMs and, therefore, may be good markers for the immunohistochemical diagnosis of primary oral AMMs. Furthermore, Melan-A may be a more sensitive marker than S-100 and HMB-45, as it has a higher SI.
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Affiliation(s)
- Yuichi Ohnishi
- Second Department of Oral and Maxillofacial Surgery, Osaka Dental University, Chuo-ku, Osaka 540-0008, Japan
| | - Masahiro Watanabe
- Second Department of Oral and Maxillofacial Surgery, Osaka Dental University, Chuo-ku, Osaka 540-0008, Japan
| | - Tomoko Fujii
- Second Department of Oral and Maxillofacial Surgery, Osaka Dental University, Chuo-ku, Osaka 540-0008, Japan
| | - Noriko Sunada
- Second Department of Oral and Maxillofacial Surgery, Osaka Dental University, Chuo-ku, Osaka 540-0008, Japan
| | - Hitoshi Yoshimoto
- Second Department of Oral and Maxillofacial Surgery, Osaka Dental University, Chuo-ku, Osaka 540-0008, Japan
| | - Hirohito Kubo
- Second Department of Oral and Maxillofacial Surgery, Osaka Dental University, Chuo-ku, Osaka 540-0008, Japan
| | - Masahiro Wato
- Department of Oral Pathology, Osaka Dental University, Hirakata-shi, Osaka 573-1121, Japan
| | - Kenji Kakudo
- Second Department of Oral and Maxillofacial Surgery, Osaka Dental University, Chuo-ku, Osaka 540-0008, Japan
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15
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Sim YC, Ahn KM, Park JY, Park CS, Son JH. Temperature-dependent terahertz imaging of excised oral malignant melanoma. IEEE J Biomed Health Inform 2015; 17:779-84. [PMID: 25055305 DOI: 10.1109/jbhi.2013.2252357] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
We imaged a single case of oral malignant melanoma using terahertz (THz) reflection imaging at room temperature (20 °C) and below freezing (-20 °C). A malignant nodule beneath the oral tissue surface was visualized using 2-D and B-scan THz imaging techniques. The THz images were well correlated with the histological findings. The nodule was found to have lower water content than that of normal cells, and this water effect may have influenced the THz refractive index and absorption coefficient at 20 °C. The THz spectroscopic image of the frozen tissue at -20 °C showed better contrast because of the lack of liquid water; this implies that there are significant structural differences between malignant oral melanoma cells and normal mucosal cells. The better contrast in the frozen tissue images was due to the greater penetration of THz radiation into the sample. This temperature-dependent THz imaging approach demonstrated the feasibility of accurate imaging of the oral tumor tissue.
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Shin OR, Chang E, Kang CS, Oh WJ, Kim YJ, Seo KJ. Primary oral melanoma presenting with cervical lymph node metastasis: a rare case report with emphasis on the role of FNA in the diagnostic approach. Diagn Cytopathol 2014; 43:264-7. [PMID: 24687813 DOI: 10.1002/dc.23166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2013] [Revised: 01/13/2014] [Accepted: 03/18/2014] [Indexed: 11/09/2022]
Affiliation(s)
- Ok Ran Shin
- Department of Hospital Pathology, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
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Oral malignant melanoma: systematic review of literature and report of two cases. Oral Surg Oral Med Oral Pathol Oral Radiol 2013; 116:e247-54. [DOI: 10.1016/j.oooo.2011.11.034] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2011] [Revised: 10/30/2011] [Accepted: 11/09/2011] [Indexed: 11/17/2022]
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Compilato D, Amato S, Campisi G. Metastatic Melanoma of the Tongue: A Rare Case. ACTAS DERMO-SIFILIOGRAFICAS 2012. [DOI: 10.1016/j.adengl.2011.12.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Compilato D, Amato S, Campisi G. Metastatic melanoma of the tongue: a rare case. ACTAS DERMO-SIFILIOGRAFICAS 2012; 103:833-6. [PMID: 22727114 DOI: 10.1016/j.ad.2011.12.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2011] [Revised: 10/17/2011] [Accepted: 12/17/2011] [Indexed: 12/31/2022] Open
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Palanivelu S, Jayanthi P, Rao UK, Joshua E, Ranganathan K. Rapidly enlarging mass following dental extraction. J Oral Maxillofac Pathol 2012; 15:223-7. [PMID: 22529586 PMCID: PMC3329701 DOI: 10.4103/0973-029x.84510] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Oral melanoma (OM) is a rare, malignant neoplasm of melanocytic origin. It accounts for 0.2 - 8% of all melanomas. In contrast to its cutaneous counterpart, OM has poor prognosis, possibly due to late clinical diagnosis, nonexistence of standardized clinical or histopathological grading and anatomical limitation in complete excision of the lesion. For better understanding of the lesion, case reports are still considered to be the source of information. Here we present a case of oral primary melanoma occurring in an uncommon site, the mandibular gingiva, with review of related literature.
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Affiliation(s)
- Sivakumar Palanivelu
- Department of Oral and Maxillofacial Pathology, Karpaga Vinayaga Institute of Dental Sciences, Chengalpet, Kancheepuram, India
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Cervantes SS, Baugh R. Primary mucosal desmoplastic melanoma of the nasal vestibule: the second case. EAR, NOSE & THROAT JOURNAL 2012; 90:483-5. [PMID: 22033960 DOI: 10.1177/014556131109001008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Primary mucosal desmoplastic melanoma is an exceedingly rare, potentially devastating disease that is often initially misdiagnosed because of its deceptively benign presentation. We report what we believe is only the second case of mucosal desmoplastic melanoma arising from the nasal vestibule. The patient, a 62-year-old woman, presented with an obstructive, enlarging mass in the nasal cavity. The tumor, which was initially believed to be benign, was excised, but it recurred 12 months postoperatively. The recurrence was excised, but 4 years later, the patient experienced a second recurrence; in this case, the tumor had invaded the cribriform plate and extended to the anterior cranial fossa. The tumor subsequently metastasized to the dura mater, which led to the patient's death. We review the distinction between conventional mucosal melanoma and mucosal desmoplastic melanoma, and we discuss the ways in which the behavior of a desmoplastic melanoma can point to the diagnosis. Because a diagnosis can be difficult to establish, we stress the importance of maintaining a high index of suspicion when evaluating pathologic and immunohistochemical findings in a patient with a recurrent mucosal nasal mass.
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Affiliation(s)
- Sergio S Cervantes
- Department of Otorhinolaryngology, Mayo Clinic Arizona, Phoenix, AZ, USA
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Guevara-Canales JO, Gutiérrez-Morales MM, Sacsaquispe-Contreras SJ, Sánchez-Lihón J, Morales-Vadillo R. Malignant melanoma of the oral cavity. Review of the literature and experience in a Peruvian Population. Med Oral Patol Oral Cir Bucal 2012; 17:e206-11. [PMID: 22143709 PMCID: PMC3448307 DOI: 10.4317/medoral.17477] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2011] [Accepted: 03/13/2011] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE To determine the epidemiological profile of malignant melanoma cases treated at the National Institute for Neoplastic Diseases "Dr. Eduardo Caceres Graziani" (INEN) over the period 1952 to 2008. STUDY DESIGN All clinical records with complete data of patients presenting a histopathological diagnosis of malignant melanoma of the oral cavity were reviewed. Data such as age, gender, location, tumor size, disease length, presence of metastasis, treatment received and year of admission were recorded. RESULTS During the study period 97 cases were found. The average age of patients was 52.85±1.6 years old mostly between 50 and 59 years old; the predominant gender was the female. The most common location was the palate and there was 58.8% of cases with a tumor size bigger than or equal to 4 cm. The length of the disease in 38.1% of the cases was longer than a year and in great part of the cases (69.1%) there was no metastasis. The treatment of choice was the surgery plus radiotherapy in 38.1% of the cases. According to the admission date it was also noted that the number of cases is increasing. CONCLUSION The results of this study demonstrate a late diagnosis and an increasing frequency of this neoplasia in the oral cavity.
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Primary mucosal malignant melanoma of the oral cavity. EUROPEAN JOURNAL OF PLASTIC SURGERY 2011. [DOI: 10.1007/s00238-011-0600-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Malignant melanoma of nasal cavity and paranasal sinuses: report of 24 patients and literature review. The Journal of Laryngology & Otology 2011; 125:479-85. [PMID: 21255478 DOI: 10.1017/s0022215110002720] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE To report our experience of the management of patients with primary sinonasal malignant melanoma, and to review the relevant medical literature. METHOD Retrospective review examining treatment and outcomes. RESULTS Twenty-four patients were treated between 1982 and 2007. The mean age at presentation was 67.5 years. The overall five-year survival was 30 per cent; mean survival was three years and eight months. CONCLUSION Sinonasal malignant melanoma is associated with a poor outcome, and survival statistics have not improved over the last 40 years. Treatment should include radical surgery wherever possible. Local recurrence is common; radiotherapy may help control this but does not appear to affect overall survival. The limited evidence available suggests that endoscopic removal of sinonasal malignant melanoma is as effective as other local surgical means, but that craniofacial resection remains the 'gold standard' for tumours that contact or traverse the skull base. Novel biological treatments are emerging and hold promise for the future.
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Vanhooteghem O, Vandenbossche G, Wauters O, Dubois JF, Müller G, de la Brassinne M. Is there a possible link between chronic trauma of the palate induced by a maxillary denture and the appearance of melanoma? Discussion of two case reports and a review of the literature. J Eur Acad Dermatol Venereol 2009; 23:615-6. [DOI: 10.1111/j.1468-3083.2008.02994.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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Femiano F, Lanza A, Buonaiuto C, Gombos F, Di Spirito F, Cirillo N. Oral malignant melanoma: a review of the literature. J Oral Pathol Med 2008; 37:383-8. [DOI: 10.1111/j.1600-0714.2008.00660.x] [Citation(s) in RCA: 72] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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Ramani P, Chandrasekar T, Narayanan V, Anuja N, Karthikeyan R, Reddy S, Senthilnathan B. Desmoplastic malignant melanoma of alveolus – A rare entity. ACTA ACUST UNITED AC 2006. [DOI: 10.1016/j.ooe.2006.08.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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López Ortega K, Soares de Araújo N, Bitu de Souza F, Magalhães MHCG. Primary malignant melanoma of the oral cavity: a case report. Int J Dermatol 2004; 43:750-2. [PMID: 15485534 DOI: 10.1111/j.1365-4632.2004.02334.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
A 43-year-old white man was referred to the Special Care Dentistry Center of the School of Dentistry, University of Sao Paulo, Brazil, for the diagnosis of an extensive nodular lesion of the maxillary gingiva. The patient complained that his left maxilla had swollen over the last 4 months, with some exudation from the gingival crevice, sporadic bleeding, and slight tooth mobility, but no pain. An extra-oral examination confirmed expressive swelling of the left side of the face (Fig. 1A). Palpation disclosed bilateral enlargement of the submandibular lymph nodes. An intra-oral examination showed an extensive, reddish, nodular mass (around 11 cm in diameter) that extended from the last left maxillary molar to the right maxillary incisor, covered by a mucosa that was ulcerated in some areas (Fig. 1B,C). Palpation revealed a painless, soft, bleeding tissue that seemed to arise in the periodontal ligaments, extending to the palate and vestibular area. A small pigmented spot was found in the palatal mass. Histopathologically, the biopsy revealed a proliferation of neoplastic cells that exhibited a wide variety of shapes, including spindle, plasmacytoid, and epithelioid forms. The atypical cells showed enlarged and pleomorphic nuclei. Mitotic activity and pigmented areas were observed (Fig. 2A,B). Immunohistochemistry was used to establish the final diagnosis. The tumor cells strongly expressed S100 protein, gp100 (HMB-45), melan A, and tyrosine antibodies (Fig. 2C,D). With the diagnosis of malignant melanoma, the patient was referred to an oncologist for treatment. As computed tomography revealed that the lesion was deeply inserted into the skull surface (Fig. 1D), surgical intervention was not possible. The patient underwent radiotherapy, but died 14 months later.
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Garzino-Demo P, Fasolis M, Maggiore GMLT, Pagano M, Berrone S. Oral mucosal melanoma: a series of case reports. J Craniomaxillofac Surg 2004; 32:251-7. [PMID: 15262258 DOI: 10.1016/j.jcms.2003.12.007] [Citation(s) in RCA: 52] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2003] [Accepted: 12/12/2003] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION Due to the rarity of oral malignant melanomas case reports are a necessary source of information. Ten new cases are reported with a minimum follow-up of 3 years. PATIENTS AND METHODS Patients were treated during a period of 10 years. Clinical, demographic and pathologic findings were examined. RESULTS In 6 males (60%) and 4 females with a mean age of 64.3 years the tumour locations were: hard palate-maxillary gingiva (3 cases), maxillary gingiva (2), lower gingiva (2), tongue (2), hard/soft palate-buccal mucosa (1). Pre-existing melanotic pigmentation had been present in 4 patients. Four patients were in stage I, 5 in stage II, and 1 in stage III. Surgical excision was the primary treatment in 9 cases. Five patients underwent simultaneous neck dissections. All patients received radiation and multimode adjuvant therapies. After a 3-year follow-up 3 patients are still alive (50% (2/4) of those presenting in stage I and 20% (1/5) in stage II). CONCLUSIONS Due to the rarity of oral melanoma, individual experience is limited. The poor prognosis and the different treatments reflect this situation.
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Treister NS, Magalnick D, Woo SB. Oral mucosal pigmentation secondary to minocycline therapy: report of two cases and a review of the literature. ACTA ACUST UNITED AC 2004; 97:718-25. [PMID: 15184854 DOI: 10.1016/j.tripleo.2003.11.006] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Minocycline is a semisynthetic broad-spectrum antimicrobial agent that was first introduced into clinical practice in 1967. The most common use of minocycline is for the long-term treatment of acne vulgaris. A well-recognized side effect of minocycline treatment is pigmentation, which has been reported in multiple tissues and fluids including thyroid, skin, nail beds, sclera, bone, and teeth. While there have been several reports of oral pigmentation following minocycline therapy, these have been, for the most part, pigmentation of the underlying bone with the overlying oral mucosa only appearing pigmented. We report two cases of actual pigmented oral mucosal lesions on the hard palate secondary to minocycline therapy with the accompanying histopathology, followed by a discussion of minocycline-induced oral pigmentation and a differential diagnosis of these lesions.
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Affiliation(s)
- Nathaniel S Treister
- Department of Oral Medicine, Infection, and Immunity, Harvard University School of Dental Medicine, Boston, MA, USA.
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31
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Prasad ML, Patel SG, Busam KJ. Primary mucosal desmoplastic melanoma of the head and neck. Head Neck 2004; 26:373-7. [PMID: 15054741 DOI: 10.1002/hed.10384] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Desmoplastic variants of melanoma rarely affect the mucosa. METHOD The clinicopathologic features and p53 status of seven primary mucosal desmoplastic melanomas of the oral and nasal cavity were studied. RESULTS The patients included six men and one woman (median age, 61 years; range, 23-74 years). Desmoplastic melanoma involved the lip in two, alveolus in three, buccal mucosa in one, and nasal vestibule in one patient. Four tumors infiltrated up to lamina propria, and three infiltrated bone and/or cartilage. All were amelanotic spindle cell tumors, five were neurotropic, and two were vasoinvasive. Aberrant p53 expression was seen in six tumors. All tumors recurred locally, and distant metastasis developed in three. Six patients died with disease (survival, 1-41 years; median, 8 years), and one patient was free of disease (survival 20 years). CONCLUSIONS Primary mucosal desmoplastic melanomas are clinically characterized by local recurrence and may lead to distant metastasis and death even after several years. Alterations in p53 expression are frequently associated with desmoplastic melanoma.
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Affiliation(s)
- Manju L Prasad
- Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York, New York, USA.
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Rapidis AD, Apostolidis C, Vilos G, Valsamis S. Primary Malignant Melanoma of the Oral Mucosa. J Oral Maxillofac Surg 2003; 61:1132-9. [PMID: 14586846 DOI: 10.1016/s0278-2391(03)00670-0] [Citation(s) in RCA: 52] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
PURPOSE The occurrence of primary oral melanoma is very rare. Large clinical series suggesting appropriate treatment modalities are lacking; the clinician has to rely on case reports to gain insight into the management of this tumor, which is much more aggressive than its skin counterpart. Patients and methods The cases of 5 patients with primary oral melanoma during a 6-year period were retrospectively reviewed. Four patients presented with tumors located in the maxilla. Preoperative workup included microscopic examination of incisional biopsy specimens for the confirmation of the diagnosis and thorough imaging of the body to rule out distant metastases. Histologically significant vertical invasion was found in all patients. No patient had distant metastases initially, and only 1 patient presented with neck disease. Primary treatment included wide local excision in 4 patients and therapeutic modified radical neck dissection in the 1 patient with neck node involvement on presentation. One patient was treated primarily with radiation therapy due to medically compromised status. Adjuvant immunochemotherapy (DAV protocol) was administered to 4 patients. Radiation therapy was used in an adjuvant fashion in 3 patients. RESULTS All of the patients developed distant metastases to the lung and liver and eventually died of their disease. Survival ranged from 14 to 38 months (mean, 25.6 months). Local recurrence occurred in 1 patient and was attributed to positive surgical margins. Contralateral neck disease developed in the patient who underwent therapeutic neck dissection. CONCLUSIONS The prognosis of primary oral melanoma remains poor despite adequate locoregional control of the disease. It seems that diagnosis is made late in the course of the disease when the primary tumor has already shed microscopic distant metastases.
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Affiliation(s)
- Alexander D Rapidis
- Department of Maxillofacial Surgery, and Vice Chairman, Division of Surgery, Greek Anticancer Institute, St Savvas Hospital, Athens, Greece.
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Primary Malignant Melanoma of the Maxillary Gingiva. Dermatol Surg 2003. [DOI: 10.1097/00042728-200303000-00022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Abstract
BACKGROUND Mucosal malignant melanoma arising from the mucosa of the head and neck region is a rare entity, accounting for approximately 0.2% of all melanomas. Most of these lesions (80%) have occurred on the maxillary anterior gingival area, especially on the palatal and alveolar mucosa. OBJECTIVE Mucosal malignant melanomas are more aggressive than cutaneous melanomas. On the other hand, complex anatomy of this area makes complete surgical excision difficult. Thus, early diagnosis and treatment are important. METHODS We presented primary malignant melanoma of the maxillary gingiva in two cases. CONCLUSION In mucosal malignant melanoma, survival rates may be increased by early diagnosis and treatment. The clinician must carefully examine oral cavity, and pigmented lesions should be biopsied. Because some melanomas may be amelanotic, a high index of suspicion is necessary.
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Affiliation(s)
- Betül Gözel Ulusal
- Department of Plastic and Reconstructive Surgery, Atatürk Training and Research Hospital, Balçova/Izmir, Turkey
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Lahoz Zamarro MT, Martínez Subias J, Muniesa Soriano JA, Laguía Pérez M. [Melanoma of the hard palate]. ACTA OTORRINOLARINGOLOGICA ESPANOLA 2001; 52:422-5. [PMID: 11526650 DOI: 10.1016/s0001-6519(01)78230-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
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.
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Affiliation(s)
- S Y Kao
- Department of Dentistry, Oral and Maxillofacial Surgery, Veterans General Hospital, and College of Dentistry, National Yang-Ming University, Taipei, Taiwan.
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Tremblay JF, O'Brien EA, Chauvin PJ. Melanoma in situ of the oral mucosa in an adolescent with dysplastic nevus syndrome. J Am Acad Dermatol 2000; 42:844-6. [PMID: 10775869 DOI: 10.1067/mjd.2000.105556] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
We describe a case of melanoma in situ occurring on the oral mucosa in an adolescent male patient who has dysplastic nevus syndrome. This association has not been previously reported and is of interest both because of the rarity of melanoma involving the oral mucosa, particularly in childhood, and because of the lack of any previous reports of oral mucosal melanoma in association with the dysplastic nevus syndrome.
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Kavanagh BD, Campbell RL, Patterson JW, O'Neill RL, Cardinale RM, Kaugars GE. Desmoplastic malignant melanoma of the palatal alveolar mucosa: sustained disease-free survival after surgery and postoperative radiotherapy. ORAL SURGERY, ORAL MEDICINE, ORAL PATHOLOGY, ORAL RADIOLOGY, AND ENDODONTICS 2000; 89:465-70. [PMID: 10760728 DOI: 10.1016/s1079-2104(00)70126-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Aggressive surgical and radiotherapeutic management of a patient with desmoplastic malignant melanoma arising from the mucosa of the oral cavity has resulted in disease-free survival of more than 2(1/2) years after diagnosis. This case represents only the tenth reported instance of desmoplastic malignant melanoma arising from the oral cavity and only the third for which survival has exceeded 2 years. Details of the clinical, histopathologic, and therapeutic features of the case are provided to augment the paucity of literature available to clinicians managing this rare disease.
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Affiliation(s)
- B D Kavanagh
- Department of Radiation Oncology, Medical College of Virginia Hospital Campus, Virginia Commonwealth University, Richmond, VA 23298-0058, USA.
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Abstract
Melanoma of the mouth is rare, most commonly occurring on the upper jaw of patients older than 50 years. Because of a frequent delay in diagnosis, the tumors are often diagnosed after they are deeper than the average cutaneous melanoma. Hence, the prognosis tends to be poor. Surgery is the mainstay of treatment, but often it is difficult because of anatomic restraints. Although melanoma is classically not very radiosensitive, occasional patients have had a good response to radiation therapy, sometimes with temporary palliation. Other treatment modalities are similar to those used for cutaneous melanoma. Immunotherapy, including interferon, has been used. Chemotherapy has a low response rate.
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Affiliation(s)
- R P Rapini
- Department of Dermatology, Texas Tech University Medical School, Lubbock 79430, USA
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Abstract
BACKGROUND Although cutaneous desmoplastic malignant melanoma (DMM) has been well characterized, those arising from the oral mucosa have been less well defined. METHODS We evaluated the clinical and pathologic features of three patients with biopsy-proven DMM examined at the North Carolina Baptist Hospital. Routine hematoxylin and eosin-stained slides were reviewed in all three cases. Sections from all cases were examined immunohistochemically using the avidin-biotin-peroxidase (ABC) technique and employing commercially available antibodies to the following antigens: S-100 protein, HMB-45, NK1C3, and cytokeratin (AE1/AE3). Appropriate positive and negative controls were utilized throughout these procedures. Clinical data were obtained from the patients' medical records. RESULTS Age at diagnosis for the three male patients were 42, 64, and 75 years. Anatomically, these neoplasms arose from the left maxillary oral mucosa (two patients) and the vermilion border of the lower lip (one patient). Initial incisional biopsies of all three patients were misinterpreted as desmoid tumor (one patient) and squamous cell carcinoma (two patients), respectively. Histologically, all tumors were poorly circumscribed and composed of fascicles and bundles of spindle-shaped cells with hyperchromatic nuclei and associated with extensive stromal collagenization. Perineural invasion was noted in two tumors. An overlying atypical, intraepidermal melanocytic proliferation was observed in two tumors. Immunohistochemically, all three tumors showed positive immunoreactivity with S-100 protein and vimentin. One tumor also expressed HMB-45. Wide surgical incision was the primary mode of therapy in all patients. One patient also received multiple courses of radiation therapy and chemotherapy. One patient died of widespread metastatic disease. CONCLUSIONS DMM of the oral mucosa is a rare, often unrecognized, form of malignant melanoma associated with a fibrosarcoma-like morphologic appearance and abundant collagenization. Meticulous attention to histomorphology and judicious use of immunohistochemical stains will help prevent misdiagnosis.
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Affiliation(s)
- S E Kilpatrick
- Department of Pathology, Wake Forest University Medical Center, Bowman Gray School of Medicine, Winston-Salem, North Carolina, USA
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