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Heifetz-Li JJ, Smith MH, Roche A. Multifocal pigmented lesions in the maxilla. Oral Surg Oral Med Oral Pathol Oral Radiol 2024; 137:205-208. [PMID: 38171999 DOI: 10.1016/j.oooo.2023.11.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2023] [Revised: 11/11/2023] [Accepted: 11/20/2023] [Indexed: 01/05/2024]
Affiliation(s)
| | | | - Ansley Roche
- Division of Otolaryngology-Head & Neck Surgery, Yale School of Medicine, New Haven, CT, USA
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Ison J, Clark A. Pigmented Lesions of the Oral Cavity. Oral Maxillofac Surg Clin North Am 2023; 35:153-158. [PMID: 37019502 DOI: 10.1016/j.coms.2022.10.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023]
Abstract
Pigmented lesions are a common finding in the oral cavity. Oral pigmented lesions may range from solitary to multiple, pinpoint to diffuse, and have a variety of clinical implications. Nearly all solitary pigmented lesions require a biopsy to rule out mucosal melanoma. Oral mucosal melanoma has a grim prognosis and early discovery is of utmost importance. Multiple pigmented lesions in the oral cavity may indicate a systemic condition about which the patient may not be aware. The presentation and management of these various lesions is the focus of this article.
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Munde AD, Karle RR, Biradar S, Mishra S. Metastatic malignant melanoma: A case of metastasis from foot to mandibular anterior region. J Cancer Res Ther 2022; 18:849-852. [PMID: 35900574 DOI: 10.4103/jcrt.jcrt_1123_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Metastatic malignant melanoma (MMM) of the oral cavity is extremely rare which generally presents in the setting of disseminated disease and have extremely poor prognosis. The most common site for MMM in the oral cavity is tongue followed by buccal mucosa for soft-tissue lesions and posterior mandible for bone involving lesions. Primary tumor sites of oral MMM are usually cutaneous lesions of the trunk, head and neck, limbs, and nasal septum mucosa. Patients bearing this diagnosis face median survival time of approximately 9 months with a probability of surviving 5 years after the initial presentation is <5%; hence, an early detection and treatment for the primary and metastatic lesion is crucial. Here, we present an unusual case of MMM of oral cavity involving gingiva and alveolar bone of the mandibular anterior region metastasizing from a primary lesion on the foot.
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Affiliation(s)
- Anita D Munde
- Department of Oral Medicine and Radiology, Rural Dental College, Pravara Institute of Medical Sciences, Loni, Maharashtra, India
| | - Ravindra R Karle
- Department of Pathology, Rural Medical College, Pravara Institute of Medical Sciences, Loni, Maharashtra, India
| | - Sudharani Biradar
- Department of Oral Medicine and Radiology, Rural Dental College, Pravara Institute of Medical Sciences, Loni, Maharashtra, India
| | - Sunil Mishra
- Department of Oral Medicine and Radiology, Dr. D. Y. Patil Dental College and Hospital, Dr. D. Y. Patil Vidyapeeth, Pimpri, Pune, Maharashtra,, India
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Markman RL, Rosa GAB, Cardili L, Simonato LE, Brandão TB, Ribeiro ACP. Tongue metastasis of cutaneous melanoma: Report of two cases and literature review. J Clin Exp Dent 2019; 10:e1130-e1134. [PMID: 30607233 PMCID: PMC6311407 DOI: 10.4317/jced.54980] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Accepted: 08/06/2018] [Indexed: 11/25/2022] Open
Abstract
Introduction Malignant metastases to the oral cavity are rare and metastatic melanomas of the tongue are considered exceptionally uncommon, with less than 10 cases published in the English literature so far. Case reports Two female patients in the 7th decade of life presented to our dental service with nodules in the tongue. Both patients had multiple metastases at the time of oral diagnosis and primary melanoma originated on the skin. An intra-oral incisional biopsy was performed under local anesthesia and the histopathologic analysis was characterized by the proliferation of atypical epithelioid cells displaying a poorly delimited cytoplasm and hyperchromatic nucleus which contained eosinophilic macronucleoli. Immunohistochemistry was performed in both cases to confirm the clinical hypothesis of metastatic melanoma. After the diagnosis of oral metastatic melanoma, the patients were maintained under palliative care and close medical follow-up. Both patients died four and a half months and 20 months after the diagnosis of tongue metastasis. Conclusions Although rare, metastatic melanoma should be included in the differential diagnosis of tongue lesions detected in patients with a previous medical history of cutaneous melanoma. Key words:Melanoma, tongue, metástases.
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Affiliation(s)
- Renata-Lucena Markman
- DDS, MSc, PhD. Oral Diagnosis Department, Semiology Area, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, São Paulo, Brazil. Av. Limeira, 901, Areão, Piracicaba, São Paulo, Brazil
| | - Giuliano-Augusto-Belizario Rosa
- DDS. Dental Oncology Service, Instituto do Câncer do Estado de São Paulo [ICESP], Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil. Av. Dr. Arnaldo, 251, Cerqueira César, São Paulo, Brazil
| | - Leonardo Cardili
- MD, MSc. Pathology Service, Instituto do Câncer do Estado de São Paulo [ICESP], Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil. Av. Dr. Arnaldo, 251, Cerqueira César, São Paulo, Brazil
| | - Luciana-Estevam Simonato
- DDS, MSc, PhD.Universidade Brasil, Campus Fernandópolis, São Paulo, Brazil. Est. Projetada F-1, s/n - Fazenda Santa Rita, Fernandópolis, São Paulo, Brazil
| | - Thais-Bianca Brandão
- DDS, MSc, PhD. Dental Oncology Service, Instituto do Câncer do Estado de São Paulo [ICESP], Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil. Av. Dr. Arnaldo, 251, Cerqueira César, São Paulo, Brazil
| | - Ana-Carolina-Prado Ribeiro
- DDS, MSc, PhD. Dental Oncology Service, Instituto do Câncer do Estado de São Paulo [ICESP], Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil. Av. Dr. Arnaldo, 251, Cerqueira César, São Paulo, Brazil
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Cervenka PD, Perez L, Perez DE, Jones B. Melanoma Metastasis to the Mandible—Case Report and Comprehensive Literature Review. J Oral Maxillofac Surg 2017; 75:2025.e1-2025.e12. [DOI: 10.1016/j.joms.2017.05.029] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2017] [Revised: 05/16/2017] [Accepted: 05/16/2017] [Indexed: 10/19/2022]
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6
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Irani S. Metastasis to the Jawbones: A review of 453 cases. J Int Soc Prev Community Dent 2017; 7:71-81. [PMID: 28462174 PMCID: PMC5390582 DOI: 10.4103/jispcd.jispcd_512_16] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2016] [Accepted: 03/05/2017] [Indexed: 12/16/2022] Open
Abstract
The purpose of the present article was to review the characteristics of the jawbone metastases to analyze all variables. A relevant English Literature search in PubMed, Scopus, and Google Scholar was performed. All variables such as age, gender, primary and secondary tumor sites were analyzed. There were 453 metastatic cases. The male-to-female ratio was 1.2:1, and the mean age of the patients was 53.4 years. The lung was the most common primary site in men, and breast in women. The most common metastatic site was the mandible, and adenocarcinoma was the most frequent histological diagnosis. Metastases to the jaw bones occur in the advanced stages of a malignancy hence; a careful examination of patients with jaw bone lesions is strongly suggested. Dentists, as well as general physicians, should take into consideration the possible presence of jaw metastases in cases which present atypical symptoms, especially in patients with known malignant disease.
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Affiliation(s)
- Soussan Irani
- Department of Oral Pathology, Dental Research Centre, Dental Faculty, Hamadan University of Medical Sciences, Hamadan, Iran
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Abstract
Malignant melanomas (MM) of the oral cavity are extremely rare, accounting for 0.2% to 8.0% of all malignant melanomas. Malignant melanomas is more frequently seen at the level of the hard palate and gingiva. Early diagnosis and treatment are important for reducing morbidity. Malignant melanoma cells stain positively with antibodies to human melanoma black 45, S-100 protein, and vimentin; therefore, immunohistochemistry can play an important role in evaluating the depth of invasion and the location of metastases. A 76-year-old man developed an oral malignant melanoma, which was originally diagnosed as a bluish reactive denture hyperplasia caused by an ill-fitting lower denture. The tumor was removed surgically, and histopathological examination revealed a nodular-type MM. There was no evidence of recurrence over a 4-year follow-up period.
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Affiliation(s)
- A Ferhat Mısır
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Bülent Ecevit University, Zonguldak, Turkey. E-mail.
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8
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Irani S. Metastasis to the oral soft tissues: A review of 412 cases. J Int Soc Prev Community Dent 2016; 6:393-401. [PMID: 27891304 PMCID: PMC5109852 DOI: 10.4103/2231-0762.192935] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2016] [Accepted: 07/22/2016] [Indexed: 12/17/2022] Open
Abstract
The present review article analyzes the characteristics of metastases to the oral soft tissues from 1937 to 2015. An extensive literature search was performed. All variables such as age, gender, and primary and secondary tumor sites were analyzed. Metastases to the major salivary glands were not included in this review. In general, there were 412 metastatic lesions developed in the oral soft tissues. The male-to-female ratio was approximately 1.8:1. The mean age of the patients at diagnosis was 58. The lung was the most common primary site and the gingiva was the most common metastatic site. The greater part of the histological examination yielded adenocarcinoma. The diagnosis of a metastatic lesion in the oral cavity is a challenge to the clinicians due to the lack of pathognomonic signs and symptoms. Oral metastases usually occur in the advanced stages of cancers, and the interval between appearance and death is usually short. The oral soft tissue metastasis can be easily recognized compared to the metastasis of jawbones. Early detection of oral lesions is important in the case of being the first sign of a malignancy in other parts of body.
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Affiliation(s)
- Soussan Irani
- Dental Research Center, Department of Oral Pathology, Dental Faculty, Hamadan University of Medical Sciences, Hamadan, Iran
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9
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Smith MH, Bhattacharyya I, Cohen DM, Islam NM, Fitzpatrick SG, Montague LJ, Damm DD, Fowler CB. Melanoma of the Oral Cavity: an Analysis of 46 New Cases with Emphasis on Clinical and Histopathologic Characteristics. Head Neck Pathol 2016; 10:298-305. [PMID: 26753505 PMCID: PMC4972758 DOI: 10.1007/s12105-016-0693-x] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2015] [Accepted: 01/06/2016] [Indexed: 02/03/2023]
Abstract
Melanoma of the oral cavity is a rare malignancy that carries a poor prognosis. We identified 46 new cases of both primary and metastatic melanoma to the oral cavity. Following IRB approval, these cases were obtained from the Oral Pathology Biopsy Service archives of the UF College of Dentistry (1994-2014), the UK College of Dentistry (1997-2015), and the UM Medical Center (1988-2015). All slides were reviewed. The location, age, race, gender, clinical impression, duration of lesion, histopathologic diagnosis, and histopathologic features were recorded. Cases from the facial skin and those with an ambiguous diagnosis were excluded. Forty-six cases fulfilled the inclusion criteria with 32 primary cases, 11 known metastases, and 3 cases where metastasis could not be excluded. The primary cases included a total of 20 females and 12 males with an average age of 66.7 (range 27-95), and the majority (80 %) of the patients were Caucasian when race was known. Twenty-two of the 32 primary cases (68.8 %) were located in the maxillary mucosa, 5 in the mandibular mucosa or bone, and 5 in other locations. The clinicians' impressions varied from benign fibrous growths to high grade malignancies. The histopathology varied widely among the cases, however two cell types predominated (often in combination): epithelioid cells (50.0 %) and spindle cells (50.0 %). Only 53.1 % demonstrated melanin pigmentation. Oral melanoma remains one of the most diverse clinical and histopathologic diagnoses. Better understanding of this neoplasm may promote earlier diagnosis and may lead to improved outcomes.
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Affiliation(s)
- Molly Housley Smith
- Division of Oral and Maxillofacial Pathology, University of Florida College of Dentistry, 1395 Center Dr, Gainesville, FL, 32610-0414, USA.
| | - Indraneel Bhattacharyya
- Division of Oral and Maxillofacial Pathology, University of Florida College of Dentistry, 1395 Center Dr, Gainesville, FL, 32610-0414, USA
| | - Donald M Cohen
- Division of Oral and Maxillofacial Pathology, University of Florida College of Dentistry, 1395 Center Dr, Gainesville, FL, 32610-0414, USA
| | - Nadim M Islam
- Division of Oral and Maxillofacial Pathology, University of Florida College of Dentistry, 1395 Center Dr, Gainesville, FL, 32610-0414, USA
| | - Sarah G Fitzpatrick
- Division of Oral and Maxillofacial Pathology, University of Florida College of Dentistry, 1395 Center Dr, Gainesville, FL, 32610-0414, USA
| | - Lindsay J Montague
- Division of Oral and Maxillofacial Pathology, University of Mississippi Medical Center, School of Dentistry, 2500 North State Street, Jackson, MS, 39216, USA
| | - Douglas D Damm
- Division of Oral and Maxillofacial Pathology, University of Kentucky College of Dentistry, MN530, 800 Rose Street, Lexington, KY, 40536-0297, USA
| | - Craig B Fowler
- Division of Oral and Maxillofacial Pathology, University of Kentucky College of Dentistry, MN530, 800 Rose Street, Lexington, KY, 40536-0297, USA
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Talebi Ardakani M, Shams B, Meimandi M, Esmaeil Nejad A, Mashhadiabbas F, Shams N. Primary Malignant Melanoma of the Oral Cavity Around Dental Implants: Report of an Unusual Case. Clin Adv Periodontics 2016; 6:105-109. [PMID: 31535467 DOI: 10.1902/cap.2016.150042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2015] [Accepted: 10/20/2015] [Indexed: 11/13/2022]
Abstract
INTRODUCTION Primary oral melanoma is an uncommon malignant tumor that originates from the proliferation of melanocytes. CASE PRESENTATION A 78-year-old man presented with a pigmented lesion around the maxillary anterior implant prosthesis. The lesion was excised and diagnosed as a melanoma. Biopsy showed a malignant pigmented neoplasm that included proliferation of dysplastic melanocytes into the superficial layers of the submucosa. Initial testing, including a positron emission tomography scan, showed no metastasis; however, after 7 months, the patient developed a cervical lymphadenopathy. A neck dissection was performed and indicated that there was metastasis of the primary melanoma. After surgery, the patient received chemotherapy. CONCLUSIONS Histologic examination of the excised lesion revealed the presence of a malignant melanoma in association with a junctional nevus of the oral mucosa. The patient was referred to the oral and maxillofacial department for further evaluation.
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Affiliation(s)
- Mohamadreza Talebi Ardakani
- Department of Periodontology, Faculty of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Bahar Shams
- Department of Periodontology, Faculty of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mansour Meimandi
- Department of Periodontology, Faculty of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Azadeh Esmaeil Nejad
- Department of Periodontology, Faculty of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fatemeh Mashhadiabbas
- Department of Oral and Maxillofacial Pathology, Faculty of Dentistry, Shahid Beheshti University of Medical Sciences
| | - Nasim Shams
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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11
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Amadeu J, Piazzetta CM, Torres-Pereira CC, Amenábar JM. Mandibular metastasis of cutaneous melanoma. J Oral Biol Craniofac Res 2016; 6:250-252. [PMID: 27761393 DOI: 10.1016/j.jobcr.2016.04.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2016] [Accepted: 04/29/2016] [Indexed: 10/21/2022] Open
Abstract
Melanoma is a malignant neoplasm of melanocytes that can metastasize to every organ of the body, but metastasis to the oral cavity is uncommon. We describe a case of metastatic malignant melanoma to the mandible in a 33-years-old woman. The patient had a 2 cm × 4 cm firm, ulcerated nodule, distal to the second mandibular right molar. Incisional biopsy revealed epithelioid cells and immunohistochemistry was positive for HMB-45, S-100 protein and vimentin. The patient was referred to the local cancer hospital for treatment but died 3 months later. Metastatic malignant melanomas of the oral cavity are rare and unusual. Early diagnosis of the primary tumor is essential for successful treatment and to improvement of patient prognosis.
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Affiliation(s)
- Josi Amadeu
- Stomatology Department, Universidade Federal do Paraná, Curitiba, PR, Brazil
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12
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Abstract
Melanoma is a malignancy most commonly arising from the skin; therefore, primary melanoma characteristics are usually the first cutaneous manifestations of melanoma. Cutaneous metastases, which can occur locally or diffusely, are important to detect in a timely manner as treatments for advanced melanoma that impact survival are now available. Melanoma can be associated with local or diffuse pigmentation changes, including depigmentation associated with the leukodermas and hyperpigmentation associated with diffuse melanosis cutis. The leukodermas occur frequently, illustrate the immunogenic nature of melanoma, and may impact prognosis. Paraneoplastic syndromes in association with melanoma are rare, though can occur.
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Affiliation(s)
- Ritva Vyas
- Department of Dermatology, University Hospitals Case Medical Center, Case Western Reserve University School of Medicine, Cleveland, OH
| | - Jacqueline Selph
- Department of Dermatology, University Hospitals Case Medical Center, Case Western Reserve University School of Medicine, Cleveland, OH
| | - Meg R Gerstenblith
- Department of Dermatology, University Hospitals Case Medical Center, Case Western Reserve University School of Medicine, Cleveland, OH.
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Kim JY, Kim H, Lim JH, Nam W. Treatment modality of malignant melanoma that metastasized to the mandible and multiple organs: A rare case report and the literature review. JOURNAL OF ORAL AND MAXILLOFACIAL SURGERY MEDICINE AND PATHOLOGY 2015. [DOI: 10.1016/j.ajoms.2014.06.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
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Mifsud M, Padhya TA. Metastatic melanoma to the upper aerodigestive tract: a systematic review of the literature. Laryngoscope 2013; 124:1143-9. [PMID: 24115042 DOI: 10.1002/lary.24436] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2013] [Revised: 08/13/2013] [Accepted: 09/09/2013] [Indexed: 12/17/2022]
Abstract
This study is a systematic review of the literature that was performed to clarify the natural history and treatment outcomes of upper aerodigestive tract metastases from cutaneous melanoma. A search of the MEDLINE database was undertaken from 1950 to 2013 to identify relevant manuscripts for this review. Article inclusion required cases with documentation of previous cutaneous melanoma primary lesions, adequate survival data, and description of metastatic treatment. Individual patient data were extracted from source articles for analysis of survival outcomes. A systematic search revealed 34 relevant articles with 37 cases for inclusion. Metastases were identified throughout the upper aerodigestive tract with a predilection for the oropharynx, larynx, and oral cavity. Treatment outcomes were estimated with the Kaplan-Meier method, with survival of 37% and 16% at 1 and 5 years, respectively. As expected from previous reports, 73% presented with disseminated disease burden with almost universally poor prognosis despite locoregional or systemic therapy. Conversely, a group of patients with limited metastatic burden had improved treatment response with a 1-year survival of 90%, denoting a hazard ratio of 9.7332 (95% confidence interval, 4.5-21.1) for disseminated disease in comparison. Upper aerodigestive tract metastases of melanoma thus are rare clinical entities that in general present in the setting of disseminated disease and evidently necessitate a focus on palliation. In contrast, for those with a limited metastatic burden, aggressive multimodality therapy including complete metastectomy can produce a significant survival advantage.
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Affiliation(s)
- Matthew Mifsud
- Department of Otolaryngology-Head and Neck Surgery, University of South Florida Morsani College of Medicine, Tampa, Florida, U.S.A
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Moreira RN, Santos CRR, Lima NL, Verli FD, Marinho SA. Oral and cutaneous melanoma: similarities and differences. J Clin Med Res 2011; 2:155-8. [PMID: 21629531 PMCID: PMC3104654 DOI: 10.4021/jocmr416w] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/15/2010] [Indexed: 02/03/2023] Open
Abstract
Melanomas are malignant lesions stemming from the disorganized proliferation of melanocytes. This condition is more common on skin, but may also be detected in mucosa, such as in the oral cavity. The aim of the present study was to report similarities and differences between oral and cutaneous melanoma.
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Affiliation(s)
- Rafaela Nogueira Moreira
- Postgraduate Program in Dentistry, Federal University of the Jequitinhonha and Mucuri Valleys (UFVJM), Diamantina, Minas Gerais, Brazil
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Hassona Y, Hughes C, Prime SS. Metastatic tumours of the tongue. Oral Oncol 2011; 47:308-11. [PMID: 21354854 DOI: 10.1016/j.oraloncology.2011.01.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2010] [Revised: 01/27/2011] [Accepted: 01/30/2011] [Indexed: 11/16/2022]
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Bouslama S, Omezzine M, Khochtali H. Métastases mandibulaires : présentation de 8 cas. ACTA ACUST UNITED AC 2010. [DOI: 10.1051/mbcb/2010035] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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18
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Müller S. Melanin-associated pigmented lesions of the oral mucosa: presentation, differential diagnosis, and treatment. Dermatol Ther 2010; 23:220-9. [PMID: 20597941 DOI: 10.1111/j.1529-8019.2010.01319.x] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Intraoral pigmentation is quite common and has numerous etiologies, ranging from exogenous to physiological to neoplastic. Many pigmented lesions of the oral cavity are associated with melanin pigment. The differential diagnosis of mucosal pigmented lesions includes hematomas, varices, and petechiae which may appear to be pigmented. Unlike cutaneous melanomas, oral melanomas are diagnosed late and have a poor prognosis regardless of depth of invasion. As such, the clinical presentation and treatment of intraoral melanoma will be discussed. Developing a differential diagnosis is imperative for a clinician faced with these lesions in order to appropriately treat the patient. This article will focus on the most common oral melanocytic lesions, along with mimics.
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Affiliation(s)
- Susan Müller
- Department of Pathology, Emory University, Atlanta, GA 30322, USA.
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Kämmerer PW, Shabazfar N, Palarie V, Kleis W, Al-Nawas B. Therapy and prognosis of extraoral malignant melanoma metastasizing to the jaw: case report and literature review. J Oral Maxillofac Surg 2010; 69:1229-34. [PMID: 20663599 DOI: 10.1016/j.joms.2010.02.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2009] [Revised: 01/18/2010] [Accepted: 02/03/2010] [Indexed: 11/17/2022]
Affiliation(s)
- Peer W Kämmerer
- Department of Oral and Maxillofacial Surgery, University Medical Center, Mainz, Germany.
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20
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Shen ML, Kang J, Wen YL, Ying WM, Yi J, Hua CG, Tang XF, Wen YM. Metastatic tumors to the oral and maxillofacial region: a retrospective study of 19 cases in West China and review of the Chinese and English literature. J Oral Maxillofac Surg 2009; 67:718-37. [PMID: 19304027 DOI: 10.1016/j.joms.2008.06.032] [Citation(s) in RCA: 61] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2007] [Revised: 02/28/2008] [Accepted: 06/16/2008] [Indexed: 01/12/2023]
Abstract
PURPOSE The aim of this article was to obtain an overview of metastatic tumors to the oral and maxillofacial (OMF) region, especially the differences in the constituent ratios of primary cancers between the United States and China. PATIENTS AND METHODS Clinical findings of 19 cases encountered in West China Hospital of Stomatology were summarized and the English and Chinese literature were reviewed and analyzed. The main clinical features of OMF metastases were summarized, with an emphasis on primary cancers' constituents. RESULTS The lung, breast, kidney, liver, and prostate were the top 5 common primary sites of cancer. However, there was a significant difference in the primary cancers' constituents between United States and China (P < .001). The breast, kidney, prostate cancers, and melanoma of skin were more frequent primary cancers in United States than in China, whereas that of the lung, thyroid, liver, esophagus, and the stomach were more common in China than in United States. The proportions of the OMF metastatic lesions originating in the lung, kidney, liver, thyroid, and esophagus in all OMF metastatic tumors were higher than the corresponding primary cancers' prevalent proportions. CONCLUSIONS The frequency of developing OMF metastasis is not always consistent with primary cancers' prevalence, which suggests that different cancers have different potentiality to develop OMF metastasis. Cancers of the kidney, liver, lung, thyroid, and esophagus were more likely to spread to the OMF region. In general screening of primary cancer, it would be helpful to take into account the metastatic potentiality of different cancers and primary cancers' prevalence in different countries in the case of occult primary.
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Affiliation(s)
- Mo-Lun Shen
- Master of Medicine, Department of Head and Neck Oncology, West China College of Stomatology, Sichuan University, Chengdu, China
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21
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Bonan PRF, Laranjeira AL, Martelli-Júnior H, Guimarães ALS, Vargas PA, Coletta RD. Synchronous Metastatic Melanoma Presenting as Gingival and Facial Swelling: A Case Report and Review of the Literature. J Periodontol 2008; 79:2371-7. [DOI: 10.1902/jop.2008.080224] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
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22
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Krahl D, Altenburg A, Zouboulis CC. Reactive hyperplasias,precancerous and malignant lesions of the oral mucosa. J Dtsch Dermatol Ges 2008; 6:217-32. [PMID: 18315622 DOI: 10.1111/j.1610-0387.2007.06625.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
The oral cavity contains many organs and tissues compressed in a small area. Accordingly oral tumors have a wide variety of appearances. Reactive hyper-plastic lesions include epulis,morsicatio,traumatic ulcer or palatal hyperplasia. These benign lesions must be separated clinically and histologically from precancerous and neoplastic lesions. In leukoplakia,the individual risk can be estimated by clinical signs. Nevertheless histopathology is mandatory because precancerous lesions usually precede or accompany most oral cancers. Amalgam tattoo,oral nevi and melanoacanthoma have to be considered as differential diagnoses of oral melanoma. Accurate clinico-pathological diagnosis is mandatory to insure appropriate therapy. Oral soft tissue tumors such as Kaposi sarcoma and multiple mucosal neuromas in MEN 2b require interdisciplinary management. Diseases affecting the minor salivary glands which may be encountered by dermatologists include mucocele, necrotizing sialometa-plasia,and tumors such as pleomorphic adenoma.
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Affiliation(s)
- Dieter Krahl
- Institute of Dermatohistology, Heidelberg, Germany.
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23
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Dimitrakopoulos I, Lazaridis N, Skordalaki A. Primary malignant melanoma of the oral cavity. Report of an unusual case. Aust Dent J 2008. [DOI: 10.1111/j.1834-7819.1998.tb00191.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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24
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Gu GM, Epstein JB, Morton TH. Intraoral melanoma: long-term follow-up and implication for dental clinicians. a case report and literature review. ACTA ACUST UNITED AC 2003; 96:404-13. [PMID: 14561964 DOI: 10.1016/s1079-2104(03)00320-2] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Primary intraoral melanoma is a rare neoplasm with a poor prognosis, accounting for 1% to 8% of all melanoma in Europe and the United States. The incidence (12%) and 5-year survival rate (17.4%) are higher in Japan. We report a case of oral lentiginous melanoma in a Japanese-American man who survived disease-free for more than 5 years after surgery, radiation therapy, and chemotherapy but developed chronic mucositis of the palate under the denture in the primary radiated field. This lesion responded to antifungal therapy. Subsequent multiple biopsies ruled out the recurrence of melanoma but demonstrated prolonged melanocytic hyperplasia and focal epithelial atypia. We reviewed clinical differences in oral melanoma reported in the United States and Japanese literature, and describe the wide variety of oral clinical features of postoperative radiation and chemotherapy, as well as the oral tissue changes caused by denture-induced mucositis and candidiasis in such patients. Dental clinicians should conduct a thorough head, neck, and oral follow-up with increased vigilance in patients with a history of prior cancer.
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Affiliation(s)
- Gao Man Gu
- Department of Oral Medicine, School of Dentistry, University of Washington, Seattle 98195, USA.
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25
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Affiliation(s)
- D Eisen
- Dermatology Research Associates, Cincinnati, Ohio 45230, USA
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26
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Lopez-Graniel CM, Ochoa-Carrillo FJ, Meneses-García A. Malignant melanoma of the oral cavity: diagnosis and treatment experience in a Mexican population. Oral Oncol 1999; 35:425-30. [PMID: 10645410 DOI: 10.1016/s1368-8375(99)00017-2] [Citation(s) in RCA: 55] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Oral malignant melanoma is uncommon, accounting for 1-8% of all malignant melanomas. All previous papers have reported small numbers of cases or have retrospectively reviewed case reports from the literature. The following case reports concern malignant melanoma of the oral cavity seen at the Instituto Nacional de Cancerología, Mexico City, during the period of 1982-96. Demographic, clinical and histopathological data were collected. Our 15 patients consisted of 6 males and 9 females. The mean age was 52.6 years (range: 35 to 80 years). The hard palate was the most common area affected with 11 cases (73%). At the time of the initial examination, a pigmented mass was apparent in 100% of the patients. All our surgical cases were treated with wide resection; 8 patients received adjuvant radiation, 4 were treated with surgery alone and 1 case received radiation and chemotherapy before the surgery. Local control of the primary lesion was possible in 14 of the 15 cases. Some patients received therapeutic or elective lymph node dissection. The median survival was 16.9 months (mean: 12.5 months). The 2- and 5-year survival rates were 26.6 and 6.6%, respectively.
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Affiliation(s)
- C M Lopez-Graniel
- Division of Surgical Oncology, Instituto Nacional de Cancerología de México, Mexico City, Mexico.
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27
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Dimitrakopoulos I, Lazaridis N, Skordalaki A. Primary malignant melanoma of the oral cavity Report of an unusual case. Aust Dent J 1998. [DOI: 10.1111/j.1834-7819.1998.tb00194.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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28
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Abstract
The appearance of distant metastases in a patient with malignant melanoma usually prophesies an early death: median survival is only 5 to 8 months. Surgery definitely can palliate certain patients and lead to a prolongation of life for others. In selected surgical candidates, an isolated nonvisceral metastasis, complete resection with free surgical margins, and a longer disease-free interval all favorably affect prognosis. In such cases, median survival can even approach 10 years, with a 5-year survival of up to 35%. Lung metastases are often incidental findings, but if complete resection can be accomplished, sometimes a median survival of 19 months and a 5-year 25% survival can be seen. Patients rarely survive long-term after brain or gastrointestinal metastases present themselves, but surgical resection extends median survival to about 10 months in this group with a significant improvement in quality of life. General guidelines should be reasonably applied for surgical intervention, with each metastatic melanoma patient given special individual assessment. Little has changed since the topic of the surgical role in metastatic melanoma was last reviewed in this journal by Coit in 1993.
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Affiliation(s)
- S M Sharpless
- Department of Surgical Oncology, University of Illinois at Chicago, 60612-7322, USA.
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29
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Selden HS, Manhoff DT, Hatges NA, Michel RC. Metastatic carcinoma to the mandible that mimicked pulpal/periodontal disease. J Endod 1998; 24:267-70. [PMID: 9641133 DOI: 10.1016/s0099-2399(98)80111-8] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
An oral cavity metastasis from a poorly differentiated carcinoma, presumed to have originated in the pancreas, mimicked a dental abscess. An additional metastasis to the lung caused a postobstructive lobar pneumonia that masked the lesion, thereby delaying the diagnosis of malignancy. This case report illustrates how the clinical manifestations of a widely disseminated neoplasm led to initial medical confusion and subsequent dental misdiagnosis, and serves to caution of a possible pitfall in the dental evaluation of endodontic lesions.
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Affiliation(s)
- H S Selden
- General Practice Residency Program, Muhlenberg Hospital Center, Bethlehem, PA, USA
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30
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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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31
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Hirshberg A, Buchner A. Metastatic tumours to the oral region. An overview. EUROPEAN JOURNAL OF CANCER. PART B, ORAL ONCOLOGY 1995; 31B:355-60. [PMID: 8746264 DOI: 10.1016/0964-1955(95)00031-3] [Citation(s) in RCA: 163] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Metastatic tumours to the oral region are uncommon. There are more published cases of jawbone metastases than in oral soft tissues. The most common primary sources of metastatic tumours to the oral region are the breast, lung, kidney, bone and colon. The breast is the most common primary site for tumours metastasising to the jawbones, whereas the lung is the most common source for metastases to the oral soft tissues. In the jawbones, the common location of the metastatic lesions is the mandible, with the molar area being the most frequent involved site. In the oral soft tissues, the attached gingiva is the most common affected site followed by the tongue. In nearly 30% of cases, the metastatic lesion in the oral region is the first indication of an undiscovered malignancy at a distant site. The biological basis of the metastatic process is discussed.
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Affiliation(s)
- A Hirshberg
- Section of Oral Pathology and Oral Medicine, Tel Aviv University, Israel
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