A primary oral mucosal melanoma of the hard palate with no recurrence: Report of a 10 years follow-up

BACKGROUND

Primary oral mucosal melanoma (OMM) represents an extremely rare and aggressive tumor that arises from malignant transformation and clonal expansion of melanocytes in the oral cavity. The prognosis of patients affected by OMM is quite unfavorable, with survival rates lower than those described for patients with cutaneous melanoma.

CASE REPORT

Here, we report a case of OMM in a 59-year-old Caucasian woman, who was referred for evaluation of a large asymptomatic pigmented lesion on the left side of the hard palate under the removable total denture. Incisional biopsy was performed, and histopathological analysis revealed the proliferation of spindle-shaped and pigmented epithelioid cells, with cellular pleomorphism. These cells were positive for Melan A, S-100, HMB-45, SOX-10, and Ki-67 confirming the diagnosis of OMM. The patient underwent partial maxillectomy and adjuvant radiotherapy. After treatment, she was rehabilitated with a palatal obturator prosthesis and has been in follow-up for 10 years with no evidence of disease. Due to the rarity in the oral cavity and the nonspecific signs and symptoms, the diagnosis of OMM is difficult and often overlooked.

CONCLUSION

Therefore, multidisciplinary management from diagnosis, treatment, and rehabilitation is important to increase the expectation of cure.

Medication-related osteonecrosis in torus palatinus: Report of a case and literature review

BACKGROUND

Medication-related osteonecrosis of the jaw bones have been frequently reported. However, its occurrence in torus palatinus is very rare with only 10 cases published in the English-language literature.

CASE REPORT

We describe an additional case in a 79-year-old woman, who was referred for evaluation of a painful swelling with areas of suppuration on the hard palate.

CONCLUSION

Conservative treatment was performed and after spontaneous sequestrectomy, total healing was achieved.

The importance of early treatment of oral squamous cell carcinoma: Case report

BACKGROUND

Oral squamous cell carcinoma (OSCC) is frequently diagnosed at an advanced stage, with the five-year survival rate varying around 50%, however, ifs the sooner OSCC in early-stage is treated, the lower the chances of recurrence and death. In this study, we described an OSCC diagnosed early, highlighting how the early surgical excision prevents the morbidity.

CASE REPORT

A 74-year-old man presented a whitish and symptomatic plaque and a discreet ulcerated area on the right lateral border of the tongue. Due to close contact with the second inferior molar, a clinical diagnosis of a frictional keratosis was suspected, however as the lesion persisted after two weeks of follow-up, an incisional biopsy was performed and the microscopic features revealed an OSCC. Early surgical resection was performed, preventing the morbidity and improve benefits to patient.

CONCLUSION

OSCC can manifest of several clinical forms, including indolent appearances, which can delay the diagnosis, and consequently the prognosis. Further, it is important to recognize and not neglect any intraoral lesions, in order to avoid the far more invasive surgery that a more advance disease would imply.

A rare case of squamous cell carcinoma of the gingiva: A diagnostic challenge

BACKGROUND

Oral squamous cell carcinoma (OSCC) of the gingiva represents less than 6% of intraoral carcinomas.

CASE REPORT

A 51-year-old male patient presented with a history of a symptomatic red spot with periods of remission and recurrence in the mandibular gingiva. On clinical examination red and white areas were observed in the gingiva, particularly around the left lower molars. Diagnosis of gingival lichen planus was suspected and topical corticosteroids was prescribed. A good clinical response was observed with reduction of symptom. The patient remained in regular follow-up and after 9 months, the lesion suddenly changed, became ulcerated and diagnosis of OSCC was established.

CONCLUSION

The clinical manifestation of OSCC can eventually mimic other even more common lesions of the oral mucosa, highlighting the importance of considering OSCC as differential diagnosis of any unexplained and persistent lesion in the oral cavity.