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Tamgadge S, Pereira T, Date A, Kalimuthu P, Tamgadge A. Oral malignant melanoma of the lower jaw-a case report with immunohistochemical investigations. Ecancermedicalscience 2023; 17:1561. [PMID: 37396106 PMCID: PMC10310326 DOI: 10.3332/ecancer.2023.1561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Indexed: 07/04/2023] Open
Abstract
Oral mucosal melanoma is a type of pigment-producing cell malignancy that primarily affects the skin and oral mucosa, but can also affect the ears, eyes, gastrointestinal tract and vaginal mucosa. Oral mucosal melanoma has several different clinical manifestations. Even though it frequently manifests as a black-brown patch, macule, or nodular lesion with varying tones of red, purple or depigmented tissue, the clinical characteristics and pathobiological behaviour of oral mucosal melanomas differ from those of cutaneous melanomas. The prognosis for oral melanomas is exceedingly bad because they frequently exhibit no symptoms, which may delay diagnosis. The case of a 65-year-old male patient with a primary complaint of blackened gums in the right lower back region of the jaw is presented here.
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Affiliation(s)
- Sandhya Tamgadge
- Department of Oral and Maxillofacial Pathology and Microbiology, School of Dentistry, D. Y. Patil University, Sector 7, Nerul, Navi Mumbai 400706, Maharashtra, India
| | - Treville Pereira
- Department of Oral and Maxillofacial Pathology and Microbiology, School of Dentistry, D. Y. Patil University, Sector 7, Nerul, Navi Mumbai 400706, Maharashtra, India
| | - Amit Date
- Department of Oral and Maxillofacial Surgery, School of Dentistry, D. Y. Patil University, Sector 7, Nerul, Navi Mumbai 400706, Maharashtra, India
| | - Priyadarshini Kalimuthu
- Department of Oral and Maxillofacial Pathology and Microbiology, School of Dentistry, D. Y. Patil University, Sector 7, Nerul, Navi Mumbai 400706, Maharashtra, India
| | - Avinash Tamgadge
- Department of Oral and Maxillofacial Pathology and Microbiology, School of Dentistry, D. Y. Patil University, Sector 7, Nerul, Navi Mumbai 400706, Maharashtra, India
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Abstract
PURPOSE OF REVIEW Mucosal melanoma is of great interest due to its aggressive behavior and less favorable prognosis. The literature is mainly case reports and case series. Here, we will collect the knowledge on mucosal melanoma from the last decade and review the literature. The main focus is being site-specific clinical features, treatment, and prognosis. RECENT FINDINGS The use of immunotherapy gain ground as for others subsets of melanoma. Anti-CTLA-4 and anti-PD-1/ PD-L1 blockade in mucosal melanoma have been evaluated in recent studies. Clinical trials are ongoing. The etiology of mucosal melanomas remains unknown. Head and neck mucosal melanomas are most common. Wide excision surgery is the treatment of choice. The effect of adjuvant therapy on survival remains questionable due to the limited knowledge. Radiotherapy seems to give better local control. The overall five-year survival rate for mucosal melanomas is 0-45%. Recent data indicates that this may be improved by the immunotherapy in the years to come.
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Affiliation(s)
- Simon Skovsted Yde
- Plastic Surgical Research Unit, Department of Plastic Surgery, Aarhus University Hospital, Noerrebrogade 44, 8000, Aarhus C, Denmark.
| | - Pia Sjoegren
- Plastic Surgical Research Unit, Department of Plastic Surgery, Aarhus University Hospital, Noerrebrogade 44, 8000, Aarhus C, Denmark
| | - Martin Heje
- Plastic Surgical Research Unit, Department of Plastic Surgery, Aarhus University Hospital, Noerrebrogade 44, 8000, Aarhus C, Denmark
| | - Lars B Stolle
- Plastic Surgical Research Unit, Department of Plastic Surgery, Aarhus University Hospital, Noerrebrogade 44, 8000, Aarhus C, Denmark
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Deyhimi P, Razavi SM, Shahnaseri S, Khalesi S, Homayoni S, Tavakoli P. Rare and Extensive Malignant Melanoma of the Oral Cavity: Report of Two Cases. JOURNAL OF DENTISTRY (SHIRAZ, IRAN) 2017; 18:227-233. [PMID: 29034279 PMCID: PMC5634364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/05/2022]
Abstract
Primary oral melanomas are uncommon malignant neoplasm of melanocytes origin. The most common site of oral melanoma is maxillary gingiva and hard palate. Oral mucosal melanoma exhibit a pathobiological behavior and clinical features different from cutaneous melanomas. Oral melanomas are often clinically silent which may consequently result in delayed diagnosis; thus, making the prognosis extremely poor. This case report presents clinical, histopathological and immunohistochemical features of two cases of advanced oral melanoma, one pigmented or melanotic melanoma in a 46-year-old female and another amelanotic melanoma in a 59-year-old male patient, with chief complaint of swelling in oral mucosa. Most oral melanomas are usually asymptomatic lesions with quick growing. Thus, the most cases are detected in late stage of diagnosis. Early diagnosis with careful examination by dentists, and early biopsy of pigmented and suspicious non-pigmented lesions would have an imperative role in more survival rate and better prognosis.
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Affiliation(s)
- Parviz Deyhimi
- Dental Research Center, Dept. of Oral and Maxillofacial Pathology, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran.
| | - Sayed Mohammad Razavi
- Dental Implant Research Center, Dept. of Oral and Maxillofacial Pathology, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran.
| | - Shirin Shahnaseri
- Dental Research Center, Dept. of Oral and Maxillofacial Surgery, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran.
| | - Saeedeh Khalesi
- Dental Implant Research Center, Dept. of Oral and Maxillofacial Pathology, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran.
| | - Solmaz Homayoni
- Dept. of Oral and Maxillofacial Pathology, School of Dentistry, Shahrekord University of Medical Sciences, Shahrekord, Iran.
| | - Payam Tavakoli
- Dept. of Oral and Maxillofacial Pathology, School of Dentistry, Islamic Azad University of Isfahan (Khorasgan), Isfahan, Iran.
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The management and site-specific prognostic factors of primary oral mucosal malignant melanoma. J Craniofac Surg 2015; 26:430-4. [PMID: 25668115 DOI: 10.1097/scs.0000000000001328] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Primary oral mucosal malignant melanoma (POMM) is uncommon. Its biological behavior is more aggressive than that of cutaneous malignant melanoma. Its site-specific prognostic factors and optimal management have not been determined yet. Retrospective POMM case analysis from peer-reviewed publications in the PubMed and Embase electronic database from January 1984 to December 2013, in which therapy and outcome data were available, was performed. A total of 151 primary cases were extracted from 39 peer-reviewed English literatures. The study population includes 63 males and 88 females with a medium age of 61 years. The treatment protocols include surgery alone (18%), radiotherapy alone (14%), surgery plus radiotherapy (14%), surgery plus chemotherapy (31%), as well as surgery plus chemoradiotherapy (15%) and chemoradiotherapy (8%). The male patients have a higher risk for metastasis than the female patients do (odds ratio [OR]; 3.41, P = 0.021). The POMM originating from specialized mucosa was associated with increased risk for tumor recurrence and mortality (OR, 4.03, P = 0.001; OR, 2.03, P = 0.031, respectively). The patients who had surgery-based multiple therapy have a significantly longer survival compared with those who had surgery alone and those who had no surgical treatment (P = 0.000). The age of 60 years or younger (hazard ratio [HR], 4.69; P = 0.000), nonsurgical treatment (HR, 12.838; P = 0.000), and surgery alone (HR, 1.517; P = 0.001) were independent adverse prognostic factors for overall survival. Taken together, the study results suggest that surgery-based multiple therapy is the most effective treatment protocol. The age of 60 years, nonsurgical treatment, and surgery alone were independent adverse prognostic factors for overall survival.
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Lamichhane NS, An J, Liu Q, Zhang W. Primary malignant mucosal melanoma of the upper lip: a case report and review of the literature. BMC Res Notes 2015; 8:499. [PMID: 26420268 PMCID: PMC4589098 DOI: 10.1186/s13104-015-1459-3] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2015] [Accepted: 09/18/2015] [Indexed: 12/13/2022] Open
Abstract
Background Malignant melanoma of oral cavity is a rare condition, accounting for 0.5 % of all oral malignancies and about 1–2 % of all melanomas. Oral melanomas have extremely poor prognosis with 5 years survival rate of 12.3 %. The poor prognosis compared to cutaneous melanoma may be attributed to delay in reporting by patient and diagnosis, and apt to become ulcerated due to repeated trauma. The ‘chameleonic’ presentation of a mainly asymptomatic condition, the rarity of these lesions, the poor prognosis and the necessity of a highly specialized treatment are factors that should be seriously considered by the involved health provider. Case presentation We present a case of 32 years old male of Han ethnicity with mucosal melanoma of upper lip, comparing his clinical presentation and histological findings at his first visit and following the recurrence. The patient complained of black discoloration on the left side of upper lip since 4 years which gradually increased in size and later involved the skin of the lip. Excision with 5 mm safety margin was performed but the patient presented with the similar lesion after three and half years of the treatment. So, again wide excision with 2 cm safety margin was performed followed by reconstruction of the lip. Conclusion This case provides an example of aggressive behavior of mucosal melanoma and emphasizes on the fact that any pigmented lesion detected in the oral cavity may exhibit potential growth and should be submitted to biopsy to exclude malignancy. It also exemplifies of how the time of diagnosis and the evolution of a disease could be seriously influenced by patient’s behavior.
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Affiliation(s)
- Narayan Sharma Lamichhane
- Department of Oral and Maxillofacial Surgery, Norman Bethune Hospital of Stomatology, Jilin University, Qinghua Road, Changchun, 130021, Jilin, People's Republic of China. .,Department of Oral and Maxillofacial Surgery, School of Stomatology, Jiamusi University, Xuefu Street, Jiamusi, 15400, Heilongjiang, China.
| | - Jiping An
- Department of Oral and Maxillofacial Surgery, Norman Bethune Hospital of Stomatology, Jilin University, Qinghua Road, Changchun, 130021, Jilin, People's Republic of China.
| | - Qilin Liu
- Department of Oral and Maxillofacial Surgery, Norman Bethune Hospital of Stomatology, Jilin University, Qinghua Road, Changchun, 130021, Jilin, People's Republic of China.
| | - Wei Zhang
- Department of Oral and Maxillofacial Surgery, Norman Bethune Hospital of Stomatology, Jilin University, Qinghua Road, Changchun, 130021, Jilin, People's Republic of China.
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Primary malignant melanoma of maxilla: report of a case with discussion. Case Rep Dent 2015; 2014:624306. [PMID: 25642350 PMCID: PMC4248399 DOI: 10.1155/2014/624306] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2014] [Revised: 10/13/2014] [Accepted: 10/21/2014] [Indexed: 11/17/2022] Open
Abstract
Primary oral malignant melanoma, very rare neoplasm of melanocytic origin, usually presents as a bluish black to tan-brown colored lesion Which is accounting for 0.2 to 8% of all melanomas, 1.6% of all head and neck malignancies, and 0.5% of all oral neoplasia. In general, the prognosis of oral melanoma is poor and worse than that of cutaneous melanoma. Here a case of oral malignant melanoma is presented, which was undetected during the first visit to a dental clinic. When a simple oral surgical treatment was carried out in that region, it resulted in the appearance of a massive pigmented lesion which was histopathologically diagnosed as malignant melanoma. This paper is presented to reemphasize the fact that any pigmented lesion in the oral cavity should be viewed with suspicion and proper investigation (biopsy) should be carried out to rule out any untoward experiences later.
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Mostafa MG, Hussein MRA, El-Ghorory RMH, Gadullah HAH. Gastric metastases from invasive primary mucosal epithelioid malignant melanoma of the hard palate: report of the first case in the English literature. Expert Rev Gastroenterol Hepatol 2014; 8:15-9. [PMID: 24410469 DOI: 10.1586/17474124.2014.859983] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Melanocytes arise from the neural crest and migrate to the epidermis, meninges, uveal tract and ectodermal mucosa. Normal gastric mucosa lacks melanocytes. A 64-year-old woman presented to us with nausea and vomiting. She had a past history of invasive primary mucosal epithelioid malignant melanoma of the hard palate 21 months ago, treated by a wide surgical excision. Gastroscopy revealed multiple punched out ulcers involving the stomach and the first part of duodenum. Immunohistology and clinicopathologic correlation established the diagnosis of metastatic gastric malignant melanoma. To our knowledge, this is the first report in the English literature about gastric metastases arising from primary palatal mucosal melanoma.
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Affiliation(s)
- Mohamed G Mostafa
- Department of Pathology, Assiut and Al-Azhar University Hospitals, Assiut University, Assiut, Egypt
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