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Arora V, Yadav V, Aggarwal M, Dewan AK. Primary Malignant Melanoma of Tongue: Rare and Aggressive Malignant Tumor. Indian J Otolaryngol Head Neck Surg 2024; 76:3586-3591. [PMID: 39130273 PMCID: PMC11306903 DOI: 10.1007/s12070-024-04624-9] [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: 12/07/2023] [Accepted: 03/08/2024] [Indexed: 08/13/2024] Open
Abstract
Primary melanoma of the oral cavity is extremely rare, accounting for 0.2-8% of all melanomas. Lesions arising from mucosal melanocytes occur most frequently on the gingiva or palate. Mucosal melanomas carry a worse prognosis than cutaneous melanomas. Very few studies have been published due to rarity of disease. 46 year old lady presented with black colored lesion over left side of her tongue for 6 weeks. On examination there was 3 × 2.5 cm black colored patch over left lateral part of tongue in middle 1/3rd, not crossing midline. Tip and base of tongue were free. Biopsy was suggestive of malignant melanoma of tongue. Patient underwent surgery (wide local excision of left lateral border of tongue lesion + left selective neck dissection). Final Histopathological report revealed malignant melanoma of tongue with all margins free, Depth of invasion 3 mm, Lympho-vascular invasion present, and no perineural invasion, left level III cervical lymph node metastases. Patient thus received adjuvant RT. Immunotherapy was also advised in multidisciplinary clinic, but patient was non-compliant. Early diagnosis will be promoted by careful oral examination and early biopsy of pigmented and non-pigmented masses. Early diagnosis and treatment will improve the prognosis of patients with oral malignant melanoma.
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Affiliation(s)
- Vikas Arora
- Department of Head Neck Oncology Rajiv Gandhi Cancer Institute & Research Centre, New Delhi, 110085 India
| | - Vishal Yadav
- Department of Head Neck Oncology Rajiv Gandhi Cancer Institute & Research Centre, New Delhi, 110085 India
| | - Manisha Aggarwal
- Department of Head Neck Oncology Rajiv Gandhi Cancer Institute & Research Centre, New Delhi, 110085 India
| | - Ajay Kumar Dewan
- Department of Head Neck Oncology Rajiv Gandhi Cancer Institute & Research Centre, New Delhi, 110085 India
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Shahina KT, Madhu SK, Ravindran V, Kumar SS, Krishnan A, Balan BC. Mucosal Melanoma of Palate: A Case Report with Review of Literature. J Maxillofac Oral Surg 2024; 23:706-709. [PMID: 38911408 PMCID: PMC11190108 DOI: 10.1007/s12663-024-02180-x] [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: 02/06/2024] [Accepted: 03/25/2024] [Indexed: 06/25/2024] Open
Abstract
The World Health Organisation defines mucosal malignant melanoma as a malignant tumour of melanocytes or of melanocyte progenitors. Due to the lack of symptoms and unknown etiology, mucosal malignant melanoma may go undiagnosed. The surgeon can find it challenging to come up with a definitive treatment strategy because of its rarity and rapid spread. In this case study, a 57-year-old female patient with hyperpigmented gingiva and palate diagnosed pathologically and immunohistochemically as malignant melanoma underwent surgical excision and a modified radical neck dissection.
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Affiliation(s)
- K. T. Shahina
- Department of Oral and Maxillofacial Surgery, Government Dental College, Kozhikode, affiliated to Kerala University of Health Sciences, Kozhikode, Kerala 673008 India
| | - Sandeep K. Madhu
- Manipal College of Dental Sciences, Mangalore Affiliated to MAHE, Hampankatta, 575006 India
| | - V. Ravindran
- Department of Oral and Maxillofacial Surgery, Government Dental College, Kozhikode, affiliated to Kerala University of Health Sciences, Kozhikode, Kerala 673008 India
| | - Sreekanth S. Kumar
- Government Tertiary Cancer Centre, Kozhikode, affiliated to Kerala University of Health Sciences, Kozhikode, 673008 India
| | - Abcish Krishnan
- Department of Oral and Maxillofacial Surgery, Government Dental College, Kozhikode, affiliated to Kerala University of Health Sciences, Kozhikode, Kerala 673008 India
| | - Babin C. Balan
- Department of Oral and Maxillofacial Surgery, Government Dental College, Kozhikode, affiliated to Kerala University of Health Sciences, Kozhikode, Kerala 673008 India
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3
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Maldonado-Mendoza J, Ramírez-Amador V, Anaya-Saavedra G. Primary oral and sinonasal mucosal melanomas in Latin America: a systematic review. Int J Oral Maxillofac Surg 2024; 53:449-460. [PMID: 38040520 DOI: 10.1016/j.ijom.2023.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 11/03/2023] [Accepted: 11/09/2023] [Indexed: 12/03/2023]
Abstract
Primary oral and sinonasal mucosal melanomas (POSNMMs) are aggressive neoplasms with limited therapeutic alternatives. The aim of this review was to characterize the demographic, clinical, immunohistochemical, and molecular information regarding these tumors in the Latin American population. Articles published in English, Spanish, or Portuguese (1990-2022) retrieved from the PubMed/MEDLINE, Scopus, CAS, Web of Science, EBSCO, and Google Academic databases were included. Thirty-three studies, with a total of 1212 cases, were identified. Clinicopathological data were available for 870 cases and immunohistochemical and/or molecular information for 342. Nineteen studies (57.6%) reported cases of oral melanoma, three (9.1%) sinonasal melanoma, and 11 (33.3%) oral and sinonasal melanoma. Fifteen studies (45.5%) provided only clinicopathological data, 12 (36.4%) reported only immunohistochemical data, two (6.1%) shared clinicopathological and immunohistochemical data, one (3.0%) offered clinicopathological, immunohistochemical, and molecular data, one (3.0%) provided immunohistochemical and molecular data, one (3.0%) clinicopathological and molecular data, and one (3.0%) only molecular data. The mean age of individuals with POSNMMs was 58 years, and slightly more were male (male 51.3%, female 48.7%). In Latin America, POSNMMs are a rare but aggressive malignancy with a poor prognosis and limited treatment options. Although molecular data and targeted therapy are still being researched, data from Latin America indicate the need for multicenter collaborative clinical trials to unite individual and isolated efforts.
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Affiliation(s)
- J Maldonado-Mendoza
- Oral Pathology and Medicine Master Program, Universidad Autónoma Metropolitana-Xochimilco, Mexico City, Mexico
| | - V Ramírez-Amador
- Oral Pathology and Medicine Master Program, Universidad Autónoma Metropolitana-Xochimilco, Mexico City, Mexico
| | - G Anaya-Saavedra
- Oral Pathology and Medicine Master Program, Universidad Autónoma Metropolitana-Xochimilco, Mexico City, Mexico.
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Kukde MM, Madurwar AU, Selokar DS, Noman O. A Case Report of Oral Malignant Melanoma: A Silent Killer. Cureus 2023; 15:e36671. [PMID: 37102023 PMCID: PMC10124672 DOI: 10.7759/cureus.36671] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Accepted: 03/25/2023] [Indexed: 03/29/2023] Open
Abstract
Melanoma of the oral cavity is a rare malignant tumor that develops from a malignant melanocytic or de novo from melanocytes within the normal mucosa or skin and appears blue, black, or reddish-brown. Oral mucosal melanoma has a higher proclivity for metastasis and attacks tissue more aggressively than any other malignant tumor in the mouth. Intestinal melanoma of the head and neck is an uncommon type of cancer that should be counted among the deadliest. Malignant melanoma of the oral cavity accounts for only 0.2%-8.0% of all reported melanoma, although accounting for 1.3% of all malignancies. Because most melanotic mucosal lesions are painless at first, the diagnosis is sometimes delayed until the ulcer or growth causes symptoms. Early detection is critical for effective therapy and the only way to improve survival and prognosis in patients with oral malignant melanoma due to its poor prognosis. To avoid oral melanomas, every single colored lesion identified in the oral cavity should be treated with suspicion and adequate inquiry because a colored lesion might expand, and it should be referred for a biopsy to avoid poisoning. This article shows how the oral clinic is important in the diagnosis of oral ulcers and argues that early detection is necessary to enhance patient outcomes.
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Venugopalan S, Makadia R, Parsana M. Oral Malignant Melanoma. Indian J Otolaryngol Head Neck Surg 2022; 74:6095-6099. [PMID: 36742579 PMCID: PMC9895477 DOI: 10.1007/s12070-021-02735-1] [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: 05/25/2021] [Accepted: 06/27/2021] [Indexed: 02/07/2023] Open
Abstract
To present a case of malignant melanoma. A 55-year old female presented with swelling over left upper gingiva which bled on brushing. She was diagnosed with left oral malignant melanoma on histopathology of punch biopsy specimen, which was then followed by C.T. P.N.S and Neck to know the lesion's extent and Ultrasonography of Abdomen and Pelvis to rule out any metastatic deposits. Patient was managed by left lower partial maxillectomy with left radical neck dissection. No intra-operative or post-operative complications seen. Patient was then sent for chemoradiotherapy. No any complications seen at fifteen months follow-up. Oral malignant melanoma is amenable to surgery and chemoradiotherapy with excellent results if detected at an early stage. Supplementary Information The online version contains supplementary material available at 10.1007/s12070-021-02735-1.
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Affiliation(s)
- Shruti Venugopalan
- P.D.U. Medical College and Hospital, Vasna Road, Vadodara-380006, Rajkot, Gujarat India
| | - Rajesh Makadia
- Head and Neck Surgery Visiting Head and Neck Surgeon, P.D.U. Medical College and Hospital, Rajkot, India
| | - Monil Parsana
- P.D.U. Medical College and Hospital, Vasna Road, Vadodara-380006, Rajkot, Gujarat India
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Chemotherapy in combination with anti-PD-1 agents as adjuvant therapy for high-risk oral mucosal melanoma. J Cancer Res Clin Oncol 2022; 149:2293-2300. [PMID: 36088610 DOI: 10.1007/s00432-022-04090-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 05/24/2022] [Indexed: 10/14/2022]
Abstract
BACKGROUND Adjuvant therapy plays a critical role in the treatment of oral mucosal melanoma (OMM). Anti-programmed cell death-1 (PD-1) agents are recommended as front-line therapy for metastatic melanoma, but their efficacy as adjuvant therapy for high-risk OMM remains unclear. PATIENTS AND METHODS A single-center, retrospective cohort study was conducted in 193 nodular-type oral mucosal melanoma (NOMM) patients who received chemotherapy alone or in combination with high-dose interferon-α2b (HDI) or anti-PD-1 agents as adjuvant therapy. Multivariate analysis was performed to identify significant prognostic factors for the 2-year overall survival (OS) and progression-free survival (PFS). RESULTS Tumor thickness, ulceration and invasion level were found to be independent prognostic factors for both 2-year OS and PFS, while T-stage was only associated with OS. The 2-year OS and PFS were 43.5% and 10.9% in patients who received only chemotherapy. In comparison, the 2-year OS was improved, albeit not significantly (47.4%; p > 0.05), and PFS was significantly improved (43.6%; p = 0.0028) in patients who received chemotherapy plus HDI; and both 2-year OS (71.0%; p = 0.0118) and PFS (53.6%; p = 0.0001) were significantly improved in patients received chemotherapy plus anti-PD-1. The serious adverse event (SAE) (p < 0.0001) and discontinued treatment due to SAE (p < 0.0001) were significantly lower in patients who received anti-PD-1 than in patients who received HDI. CONCLUSIONS Invasion level and tumor thickness are independent prognostic factors for NOMM. Chemotherapy plus anti-PD-1 agents seem to be the adjuvant therapy of choice for NOMM, as it is safer and more tolerable than HDI and, more importantly, it can significantly improve the OS and PFS.
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Lygeros S, Danielidi A, Tzelepi V, Grafanaki K. An Unusual Polypoid Septal Mucosal Melanoma: Overview and Diagnostic Pitfalls. Cureus 2021; 13:e20819. [PMID: 35141076 PMCID: PMC8802658 DOI: 10.7759/cureus.20819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/29/2021] [Indexed: 11/05/2022] Open
Abstract
Sinonasal mucosa is an area of high melanocyte density compared to other mucosa-lined sites. Sinonasal mucosal melanomas (SNMM) most commonly arise from the nasal cavity and the paranasal sinuses. Due to their obscure anatomic location and lack of early symptomatology, SNMM are often diagnosed in an advanced stage. The majority of patients who present with symptoms complain of unilateral nasal dysfunction, such as obstruction and epistaxis. We hereby report a case of an 86-year-old female, who presented with a three-year history of progressive right-sided nasal obstruction and recurrent epistaxis. Posterior rhinoscopy and endoscopy revealed a polypoid, fleshy lesion whose coloration varied from mildly pigmented to amelanotic. Inverted sinonasal papilloma was included in the differential diagnosis due to MRI findings. Post-resection histopathology indicated a mucosal melanoma. Typically, amelanotic lesions are rare, more difficult to diagnose and associated with worse prognosis due to both their aggressiveness and delayed diagnosis.
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9
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Aloua R, Kaouani A, Kerdoud O, Salissou I, Slimani F. Melanoma of the oral cavity: A silent killer. Ann Med Surg (Lond) 2021; 62:182-185. [PMID: 33532067 PMCID: PMC7829076 DOI: 10.1016/j.amsu.2021.01.026] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Revised: 01/12/2021] [Accepted: 01/12/2021] [Indexed: 02/03/2023] Open
Abstract
Melanoma of the mouth is a rare entity of cancer. It has a bad prognosis. We report two cases of mouth melanoma. In the first case, 68 years old man developed a mandibular gingival tumor. Head and neck MRI scans showed an aggressive tumor process in the mouth with bone extension and in the deep spaces. The patient was free of cervical lymph nodes. The second case is a 75-years-old male with heavy tobacco smoke. The man felt a burgeoning mass on the right palate. The neck palpation found a firm mobile non-tender mass at the left upper jugular region. The anatomopathological study of the biopsies assigned both cases to malignant melanoma. Because of the rarity and delays in diagnosis, case reports are an invaluable source of information. Melanoma of the mouth is a rare entity of cancer with a bad prognosis. Tobacco and alcohol use are two of the most important risk factors for oral cavity and oropharyngeal cancers. Maxillofacial surgeons and physicians who treat oral lesions must be conscious of the need for early diagnosis of melanoma.
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Affiliation(s)
- Rachid Aloua
- Oral and Maxillofacial Surgery Department, CHU Ibn Rochd, B.P 2698, Casablanca, Morocco
| | - Amine Kaouani
- Oral and Maxillofacial Surgery Department, CHU Ibn Rochd, B.P 2698, Casablanca, Morocco
- Corresponding author.
| | - Ouassime Kerdoud
- Oral and Maxillofacial Surgery Department, CHU Ibn Rochd, B.P 2698, Casablanca, Morocco
| | - Iro Salissou
- Oral and Maxillofacial Surgery Department, CHU Ibn Rochd, B.P 2698, Casablanca, Morocco
| | - Faiçal Slimani
- Faculty of Medicine and Pharmacy, Hassan II University of Casablanca, B.P 5696, Casablanca, Morocco
- Oral and Maxillofacial Surgery Department, CHU Ibn Rochd, B.P 2698, Casablanca, Morocco
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10
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Nenclares P, Ap Dafydd D, Bagwan I, Begg D, Kerawala C, King E, Lingley K, Paleri V, Paterson G, Payne M, Silva P, Steven N, Turnbull N, Yip K, Harrington KJ. Head and neck mucosal melanoma: The United Kingdom national guidelines. Eur J Cancer 2020; 138:11-18. [PMID: 32829104 DOI: 10.1016/j.ejca.2020.07.017] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Revised: 07/03/2020] [Accepted: 07/19/2020] [Indexed: 01/10/2023]
Abstract
The United Kingdom head and neck mucosal melanoma guideline development group used an evidence-based systematic approach to make recommendations in key areas of uncertainty in the field, including accurate diagnosis and staging; the appropriate treatment pathway including surgery, adjuvant radiation and new systemic treatments, such as targeted agents and immunotherapy; and the surveillance of patients after treatment. The guidelines were sent for international peer review and have been accredited by the National Institute for Health and Care Excellence. A summary of key recommendations is presented. The full documents are available on the Melanoma Focus website (https://melanomafocus.com/activities/mucosal-guidelines/mucosal-melanoma-resources/).
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Affiliation(s)
| | | | - Izhar Bagwan
- Royal Surrey County Hospital NHS Foundation Trust, Surrey, UK
| | - Donna Begg
- University Hospitals Birmingham, Birmingham, UK
| | | | - Emma King
- Poole Hospital NHS Foundation Trust, Dorset, UK
| | | | - Vinidh Paleri
- Royal Marsden Hospital NHS Foundation Trust, London, UK; The Institute of Cancer Research, London, UK
| | | | - Miranda Payne
- Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Priyamal Silva
- Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Neil Steven
- University Hospitals Birmingham, Birmingham, UK
| | | | - Kent Yip
- East Suffolk and North Essex NHS Foundation Trust, UK
| | - Kevin J Harrington
- Royal Marsden Hospital NHS Foundation Trust, London, UK; The Institute of Cancer Research, London, UK
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11
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Limongelli L, Cascardi E, Capodiferro S, Favia G, Corsalini M, Tempesta A, Maiorano E. Multifocal Amelanotic Melanoma of the Hard Palate: A Challenging Case. Diagnostics (Basel) 2020; 10:E424. [PMID: 32580507 PMCID: PMC7344725 DOI: 10.3390/diagnostics10060424] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 06/17/2020] [Accepted: 06/18/2020] [Indexed: 12/26/2022] Open
Abstract
Among all melanomas, the mucosal type is very rare and may occur in the sino-nasal mucosa, vagina, anus and the oral cavity. At variance with melanomas of the skin, no risk factors, such as familiarity, UV-exposure and skin phenotype, have been clearly identified for such neoplasms. Frequently, the diagnosis is delayed and achieved at advanced stages or when metastases have already occurred. The authors report on a case of mucosal melanoma of the oral cavity presenting as a mass of the hard palate in a 50-year old male, and the corresponding diagnostic-therapeutic pathway.
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Affiliation(s)
- Luisa Limongelli
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, Piazza G. Cesare 11, 70124 Bari, Italy; (L.L.); (G.F.); (M.C.); (A.T.)
| | - Eliano Cascardi
- Department of Emergency and Organ Transplantation, University of Bari “Aldo Moro”, Piazza G. Cesare 11, 70124 Bari, Italy; (E.C.); (E.M.)
| | - Saverio Capodiferro
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, Piazza G. Cesare 11, 70124 Bari, Italy; (L.L.); (G.F.); (M.C.); (A.T.)
| | - Gianfranco Favia
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, Piazza G. Cesare 11, 70124 Bari, Italy; (L.L.); (G.F.); (M.C.); (A.T.)
| | - Massimo Corsalini
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, Piazza G. Cesare 11, 70124 Bari, Italy; (L.L.); (G.F.); (M.C.); (A.T.)
| | - Angela Tempesta
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, Piazza G. Cesare 11, 70124 Bari, Italy; (L.L.); (G.F.); (M.C.); (A.T.)
| | - Eugenio Maiorano
- Department of Emergency and Organ Transplantation, University of Bari “Aldo Moro”, Piazza G. Cesare 11, 70124 Bari, Italy; (E.C.); (E.M.)
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12
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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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Majidi FS, Mohammadi E, Mehravi B, Nouri S, Ashtari K, Neshasteh-Riz A. Investigating the effect of near infrared photo thermal therapy folic acid conjugated gold nano shell on melanoma cancer cell line A375. ARTIFICIAL CELLS NANOMEDICINE AND BIOTECHNOLOGY 2019; 47:2161-2170. [PMID: 31159585 DOI: 10.1080/21691401.2019.1593188] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Nowadays, there is growing interest regarding the use of metal Nanoshells as targeted agents of Nano-photo thermal cancer therapy. This study was aimed at synthesis the folic acid (FA)-conjugated with silica @gold core-shell nanoparticles (FA-SiO2@AuNPs) for improving the treatment of melanoma cancer cells. The characterization data showed that the FA-SiO2@AuNPs is spherical in shape and its size is ∼73.7 nm. The intracellular uptake of FA-SiO2@AuNPs into melanoma cells (A375) was measured through the inductively coupled plasma, (∼47.7%). The cytotoxicity of nanoparticles was investigated on A375 and HDF (Human dermal fibroblast) cell lines. Cytotoxicity results indicated that there is no significant cytotoxicity in HDF cell lines treated with nanoparticles. MTT and flow cytometry results showed that the viability of A375 cells treated by SiO2@Au and FA-SiO2@AuNPs was decreased significantly to about 31% and 16% respectively. The higher toxicity of cancer cells was obtained for the cells exposed to 808 nm near-infrared (NIR) laser after incubation with FA-SiO2@AuNPs rather than the non-targeted SiO2@AuNPs. Furthermore, about 64% more cell death was observed for A-375 cells using both photothermal therapy and treatment with FA-SiO2@AuNPs compared to photothermal therapy. Additionally, the majority of the cell deaths were related to the apoptosis process, not necrosis. It can be concluded that FA-SiO2@AuNPs was an effective targeting agent for photothermal therapy in the treatment of melanoma.
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Affiliation(s)
- Fateme Sadat Majidi
- a Radiation Biology Research Center, Iran University of Medical Sciences , Tehran , Iran.,c Cellular and Molecular Research Center, Iran University of Medical Sciences , Tehran , Iran
| | - Elham Mohammadi
- b Department of Medical Nanotechnology, Faculty of Medical Nanotechnologies, University of Medical Sciences , Tehran , Iran
| | - Bita Mehravi
- b Department of Medical Nanotechnology, Faculty of Medical Nanotechnologies, University of Medical Sciences , Tehran , Iran
| | - Samira Nouri
- a Radiation Biology Research Center, Iran University of Medical Sciences , Tehran , Iran.,c Cellular and Molecular Research Center, Iran University of Medical Sciences , Tehran , Iran
| | - Khadije Ashtari
- b Department of Medical Nanotechnology, Faculty of Medical Nanotechnologies, University of Medical Sciences , Tehran , Iran
| | - Ali Neshasteh-Riz
- a Radiation Biology Research Center, Iran University of Medical Sciences , Tehran , Iran
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14
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Ikawa H, Koto M, Demizu Y, Saitoh JI, Suefuji H, Okimoto T, Ohno T, Shioyama Y, Takagi R, Hayashi K, Nemoto K, Nakano T, Kamada T. Multicenter study of carbon-ion radiation therapy for nonsquamous cell carcinomas of the oral cavity. Cancer Med 2019; 8:5482-5491. [PMID: 31369213 PMCID: PMC6745861 DOI: 10.1002/cam4.2408] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Revised: 06/25/2019] [Accepted: 06/25/2019] [Indexed: 12/13/2022] Open
Abstract
Background The aim of this study was to evaluate the efficacy and safety of carbon‐ion radiation therapy for nonsquamous cell carcinomas of the oral cavity in a multicenter study. Methods Retrospective analysis of the clinicopathological features and outcomes of 76 patients with oral nonsquamous cell carcinomas with N0‐1 M0 status and were treated with carbon‐ion radiation therapy at four institutions in Japan between November 2003 and December 2014 was performed. Results Salivary gland carcinoma, mucosal melanoma, and three other carcinomas were found in 46, 27, and 3 patients, respectively. T1‐3, T4a, and T4b disease was diagnosed in 27, 18, and 31 patients, respectively. Median follow‐up period was 31.1 months (range, 3‐118 months). Three‐year local control, progression‐free survival, and overall survival of all patients were 86.8%, 63.1%, and 78.4%, respectively. Multivariate analysis showed T classification (T4) to be a significant independent poor prognostic factor for local control. Acute grade 3 mucositis was observed in 38 patients. Grades 3 and 4 late morbidities were observed in 9 and 4 patients, respectively. No grade 5 late toxicity was observed. Conclusions Oral nonsquamous cell carcinomas could be treated effectively, with acceptable toxicity, by carbon‐ion radiation therapy.
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Affiliation(s)
- Hiroaki Ikawa
- Hospital of the National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Sciences and Technology, Chiba, Japan
| | - Masashi Koto
- Hospital of the National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Sciences and Technology, Chiba, Japan
| | - Yusuke Demizu
- Department of Radiology, Hyogo Ion Beam Medical Center, Tatsuno, Japan
| | | | | | - Tomoaki Okimoto
- Department of Radiology, Hyogo Ion Beam Medical Center, Tatsuno, Japan
| | - Tatsuya Ohno
- Gunma University Heavy Ion Medical Center, Maebashi, Japan
| | | | - Ryo Takagi
- Department of Oral Pathobiological Science and Surgery, Tokyo Dental College, Tokyo, Japan
| | - Kazuhiko Hayashi
- Hospital of the National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Sciences and Technology, Chiba, Japan
| | - Kenji Nemoto
- Department of Radiation Oncology, Faculty of Medicine, Yamagata University, Yamagata, Japan
| | - Takashi Nakano
- Gunma University Heavy Ion Medical Center, Maebashi, Japan
| | - Tadashi Kamada
- Hospital of the National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Sciences and Technology, Chiba, Japan
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15
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Maldonado-Mendoza J, Ramírez-Amador V, Anaya-Saavedra G, Ruíz-García E, Maldonado-Martínez H, Fernández Figueroa E, Meneses-García A. CD117 immunoexpression in oral and sinonasal mucosal melanoma does not correlate with somatic driver mutations in the MAPK pathway. J Oral Pathol Med 2019; 48:382-388. [PMID: 30873641 DOI: 10.1111/jop.12849] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Revised: 02/11/2019] [Accepted: 03/11/2019] [Indexed: 12/22/2022]
Abstract
BACKGROUND Mutations on KIT and downstream genes of MAPK pathway that overstimulate cellular proliferation have been associated with primary oral and sinonasal melanomas (POSNM), but there is limited information that allows the use of personalized therapy. Thus, the aim of the present study was to determine a possible association between the C-KIT immunohistochemical expression with the presence of somatic driver mutations in NRAS, BRAF, KIT, MITF and PTEN on POSNM. METHODS A retrospective study included 62 tumour samples of an oncological reference centre in Mexico City (17-year period). Immunohistochemistry stain of C-KIT was carried out. Genomic DNA was obtained and used to assess hotspot mutations of KIT, NRAS, BRAF, MITF and PTEN through qPCR. Chi-square, Fisher's exact and the Mann-Whitney U tests were applied when necessary. The significance was set at P < 0.05. RESULTS Sixty-two cases were included, 74% were positive for C-KIT immunoexpression, all exhibited moderate/strong intensity. Ten (16.1%) samples harboured at least one mutation, 6.4% and 6.6% for NRASQ 61R and BRAFV 600E , respectively, followed by KITK624E (3.2%). No KITL 576P , MITF or PTEN mutations were identified. No significant correlation was observed between mutations and immunostaining (rs = -0.057, P = 0.765). CONCLUSIONS Regardless of the high immunoexpression of C-KIT, there was no association with the MAPK mutations among POSNM samples. Thus, C-KIT immunohistochemistry is not a reliable tool to detect POSNM candidates for biological therapy.
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Affiliation(s)
- Jessica Maldonado-Mendoza
- Doctorate in Health and Biological Sciences Program, Universidad Autónoma Metropolitana-Xochimilco, Mexico City, Mexico
| | - Velia Ramírez-Amador
- Health Care Department, Oral Pathology and Medicine Master, Universidad Autónoma Metropolitana-Xochimilco, Mexico City, Mexico
| | - Gabriela Anaya-Saavedra
- Health Care Department, Oral Pathology and Medicine Master, Universidad Autónoma Metropolitana-Xochimilco, Mexico City, Mexico
| | - Erika Ruíz-García
- Traslational Research Laboratory, Instituto Nacional de Cancerología, Mexico City, Mexico
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The existence of early stage oral mucosal melanoma: A 10-year retrospective analysis of 170 patients in a single institute. Oral Oncol 2018; 87:70-76. [PMID: 30527246 DOI: 10.1016/j.oraloncology.2018.10.022] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2018] [Revised: 10/15/2018] [Accepted: 10/17/2018] [Indexed: 12/21/2022]
Abstract
BACKGROUND Oral mucosal melanoma (OMM) is an aggressive tumor with an extremely low incidence, and the current TNM Staging System has classified all OMMs as high stage. However, controversy remains regarding the existence of early stage OMMs. PATIENTS AND METHODS The clinical and pathological features, treatments and outcomes of 170 OMM patients treated in a single institution from January 2007 to July 2017 were retrospectively analyzed. Multivariate analysis was performed to identify significant prognostic factors for overall survival (OS). RESULTS Multivariate analysis identified positive cervical lymph nodes (p < 0.0001), nodular OMMs (p < 0.0001), ulceration (p = 0.002), and level III or level IV invasion (p < 0.0001) as independent poor prognostic factors for OS. Nodular OMM patients with a tumor size ≤1 cm had a better outcome than those with a tumor size >1 cm (p < 0.0001). Twenty-two patients with superficial invasion had a favorable survival without the need of adjuvant therapy (postoperative chemotherapy or radiotherapy), and the current TNM Staging System was not suitable for those patients. Patients with deep invasion were more likely to suffer from recurrence and distant metastasis. CONCLUSIONS Tumor size ≤1 cm and OMM in situ, although extremely rare, do exist. It is advisable for AJCC to consider tumor size ≤1 cm and OMM in situ as the early stage of OMM when updating the new Oral Melanoma Staging System.
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17
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Abstract
Primary melanoma of the oral cavity is extremely uncommon tumour consisting approximately 0.2 - 8.0% of all melanoma cases and 0.5% of all oral malignancies. It has an aggressive behaviour and poor prognosis, with 5 - year - survival rate between 5 - 20%. The initial symptoms are often unnoticed, which lead to late diagnosis and worsening of the prognosis. Because of its infrequent occurrence, there is no well - defined classification and therapeutic protocol, in contrast to melanomas of another side. Early diagnosis and treatment are essentially linked to survival rate. We present a case of palatal melanoma in a 76 - year - old female patient, as we want to emphasise the importance of the early detection and accurate diagnosis of melanoma of oral cavity, to its influence of the therapeutic outcome.
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Affiliation(s)
- Georgi Tchernev
- Medical Institute of Ministry of Interior (MVR), Department of Dermatology, Venereology and Dermatologic Surgery, Sofia, Bulgaria.,Onkoderma - Policlinic for Dermatology and Dermatologic Surgery, Sofia, Bulgaria
| | - Torello Lotti
- Department of Dermatology, University of Rome "G. Marconi" Rome, Italy.,Department of Biotechnology, Delft University of Technology, 2628 BC, Delft, The Netherlands
| | - Uwe Wollina
- Städtisches Klinikum Dresden, Department of Dermatology and Allergology, Dresden, Sachsen, Germany
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18
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Naganawa K, Koto M, Takagi R, Hasegawa A, Ikawa H, Shimozato K, Kamada T, Okamoto Y. Long-term outcomes after carbon-ion radiotherapy for oral mucosal malignant melanoma. JOURNAL OF RADIATION RESEARCH 2017; 58:517-522. [PMID: 28028129 PMCID: PMC5570020 DOI: 10.1093/jrr/rrw117] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/09/2016] [Revised: 10/12/2016] [Accepted: 12/20/2016] [Indexed: 06/06/2023]
Abstract
Oral mucosal malignant melanoma (OMM) is extremely rare and has a poor prognosis. Owing to its rarity, it has not yet been possible to establish an optimal treatment modality. The objective of this study was to evaluate the long-term efficacy of carbon-ion radiotherapy (C-ion RT) for OMM. Between 1997 and 2013, 19 patients with OMM were treated with C-ion RT alone. Patient ages ranged from 44 to 84 years (median, 69 years). Nine men and 10 women were included. OMMs were restaged in accordance with the seventh edition of the tumour/node/metastasis (TNM) Staging System of the International Union Against Cancer. Before treatment, 14 patients had T3 disease and 5 had T4a disease. Three patients were classified as having N1 disease. All patients were classified as having M0. The hard palate was the most frequently involved oral subsite. All patients were treated with 57.6 Gy (relative biological effectiveness) in 16 fractions. The median follow-up period was 61 months (range, 8-190 months). The 5-year local control, overall survival and progression-free survival rates were 89.5%, 57.4% and 51.6%, respectively. For local control and overall survival, T classification was found to be a significant prognostic factor. Grade 2 and 3 osteoradionecrosis was observed in three and four patients, respectively. The presence of teeth within the planning target volume was a significant risk factor for developing osteoradionecrosis. C-ion RT was an effective treatment option with acceptable toxicity for OMM.
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Affiliation(s)
- Kensuke Naganawa
- National Institute of Radiological Sciences Hospital, National Institutes for Quantum and Radiological Sciences and Technology, 4-9-1 Anagawa, Inage-ku, Chiba 263-8555, Japan
- Department of Oral and Maxillofacial Surgery, Aichi Gakuin University, School of Dentistry, 2-11 Suemori-dori, Chikusa-ku, Nagoya, Aichi 464-8651, Japan
| | - Masashi Koto
- National Institute of Radiological Sciences Hospital, National Institutes for Quantum and Radiological Sciences and Technology, 4-9-1 Anagawa, Inage-ku, Chiba 263-8555, Japan
| | - Ryo Takagi
- National Institute of Radiological Sciences Hospital, National Institutes for Quantum and Radiological Sciences and Technology, 4-9-1 Anagawa, Inage-ku, Chiba 263-8555, Japan
| | - Azusa Hasegawa
- National Institute of Radiological Sciences Hospital, National Institutes for Quantum and Radiological Sciences and Technology, 4-9-1 Anagawa, Inage-ku, Chiba 263-8555, Japan
| | - Hiroaki Ikawa
- National Institute of Radiological Sciences Hospital, National Institutes for Quantum and Radiological Sciences and Technology, 4-9-1 Anagawa, Inage-ku, Chiba 263-8555, Japan
| | - Kazuo Shimozato
- Department of Oral and Maxillofacial Surgery, Aichi Gakuin University, School of Dentistry, 2-11 Suemori-dori, Chikusa-ku, Nagoya, Aichi 464-8651, Japan
| | - Tadashi Kamada
- National Institute of Radiological Sciences Hospital, National Institutes for Quantum and Radiological Sciences and Technology, 4-9-1 Anagawa, Inage-ku, Chiba 263-8555, Japan
| | - Yoshitaka Okamoto
- Department of Otolaryngology, Chiba University Graduate School of Medicine, 1-8-1 Inohara, Chuo-ku, Chiba 260-8677, Japan
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19
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Lee RJ, Lee SA, Lin T, Lee KK, Christensen RE. Determining the epidemiologic, outcome, and prognostic factors of oral malignant melanoma by using the Surveillance, Epidemiology, and End Results database. J Am Dent Assoc 2017; 148:288-297. [DOI: 10.1016/j.adaj.2017.01.019] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2016] [Revised: 01/18/2017] [Accepted: 01/19/2017] [Indexed: 12/23/2022]
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20
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Kumar V, Vishnoi JR, Kori CG, Gupta S, Misra S, Akhtar N. Primary malignant melanoma of oral cavity: A tertiary care center experience. Natl J Maxillofac Surg 2016; 6:167-71. [PMID: 27390490 PMCID: PMC4922226 DOI: 10.4103/0975-5950.183856] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Background: Primary mucosal malignant melanoma is an extremely rare, aggressive neoplasm accounting for 0.5% of all oral malignancies. Any pigmented lesion in oral cavity should have an index of suspicion, which should be investigated to detect the disease at an early stage and managed appropriately. Melanomas tend to invade locally into the tissue or metastasize more commonly than other malignant tumors of the oral cavity. Materials and Methods: We report a retrospective case series of eight patients suffering from primary oral malignant melanoma treated in our department between 2012 and 2014. The details were recorded from the departmental computerized database and patients on follow-up. Results: There were six male and two female patients with a mean age of 46.8 years. Hard palate was the most common affected site in oral cavity. Pigmented lesion\ulcer was the most common presenting symptom. Majority of patients (5 patients) were diagnosed with Stage III (distant metastasis), two patients in Stage II, and one patient in Stage I. Three patients were treated with definitive surgery and five patients with palliative chemotherapy in view of distant disease. Following surgery, two of them required adjuvant chemoradiotherapy in view of nodal spread. Patients had a mean follow-up of 10.5 months (range: 8–26 months). Patients treated with definitive surgery had a mean survival rate of 16 months (range: 10–26 months), with local recurrence in one patient. Metastatic melanoma patients treated with palliative chemotherapy had a mean disease control rate of 5 months (range 5–9 months). Conclusion: Oral melanoma carries dismal prognosis with a 5-year survival rate of 5–20%. Early detection of the lesion, proper evaluation, and appropriate treatment are very important to cure the disease.
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Affiliation(s)
- Vijay Kumar
- Department of Surgical Oncology, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Jeewan Ram Vishnoi
- Department of Surgical Oncology, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Channabasappa G Kori
- Department of Surgical Oncology, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Sameer Gupta
- Department of Surgical Oncology, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Sanjeev Misra
- All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Naseem Akhtar
- Department of Surgical Oncology, King George's Medical University, Lucknow, Uttar Pradesh, India
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21
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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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22
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Rathore RS, Phulari RG, Vasavada DG, Patel DK. A Rare and Extensive Case of Oral Malignant Melanoma involving Mandibular Gingiva. J Clin Diagn Res 2016; 10:ZD11-2. [PMID: 27042595 DOI: 10.7860/jcdr/2016/17423.7320] [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: 10/19/2015] [Accepted: 01/16/2016] [Indexed: 11/24/2022]
Abstract
Oral malignant melanoma is an infrequent but an aggressive neoplasm of unknown etiology, seen most commonly in middle age male patients and is more frequently seen at the hard palate and gingiva. The tumor tends to metastasize or locally invade tissue more readily than other malignant tumors in the oral region. In this article, we report a rare case of extensive oral melanoma in a 55-year-old male patient, with a chief complaint of painless growth in mandibular anterior gingiva measuring about 2.6 X 1.7 X 0.8 cm and extending bilaterally till posterior mandibular gingiva and unilaterally to right buccal mucosa. The most common site being hard palate and maxillary gingiva, it is extremely rare in mandibular gingiva (less than 7%) and hence, this rare occurrence in mandibular gingiva is reported, the diagnosis of which was confirmed by histopathology and immunohistochemistry.
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Affiliation(s)
- Rajendrasinh S Rathore
- Professor and Head of Department, Department of Oral Pathology, Manubhai Patel Dental College & Hospital , Vadodara, Gujarat, India
| | - Rashmi Gs Phulari
- Professor, Department of Oral Pathology, Manubhai Patel Dental College & Hospital , Vadodara, Gujarat, India
| | - Dharmesh G Vasavada
- Senior Lecturer, Department of Oral Pathology, Manubhai Patel Dental College & Hospital , Vadodara, Gujarat, India
| | - Dipen K Patel
- Senior Lecturer, Department of Oral Pathology, Manubhai Patel Dental College & Hospital , Vadodara, Gujarat, India
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23
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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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24
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Maldonado-Mendoza J, Ramírez-Amador V, Anaya-Saavedra G, Irigoyen-Camacho ME, Ruíz-Godoy L, Ruíz-García E, Meneses-García A. Clinicopathological characterization of primary oral and sinonasal melanoma in a referral centre in Mexico City: 2000-2012. Int J Oral Maxillofac Surg 2014; 44:427-32. [PMID: 25467736 DOI: 10.1016/j.ijom.2014.10.022] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2014] [Revised: 10/22/2014] [Accepted: 10/29/2014] [Indexed: 02/03/2023]
Abstract
In Mexico, there have been few studies on primary oral and sinonasal melanoma, an aggressive neoplasm with a low survival rate and few therapeutic alternatives. Further, there is limited information about its clinical and histopathological characteristics. The aim of this retrospective study was to describe the clinicopathological profile of these tumours in patients attending a major oncology reference centre in Mexico City over a 12-year period. Demographic and clinical data were obtained from the clinical charts, and histopathological features were evaluated. χ(2), Fisher's exact, and Mann-Whitney U-tests were used for analysis; significance was set at P<0.05. Thirty-three cases were studied (73% sinonasal melanoma (SNM) and 27% oral melanoma (OM)); 58% were female and the median age was 66 (Q1-Q3 55.5-75) years. Compared with OM patients, SNM patients had a shorter time to diagnosis (16.7 vs. 11.7 months, P=0.022), were identified at earlier stages (33.3% vs. 58.3%, P=0.010), and all presented symptoms (66.7% vs. 100%, P=0.015). All samples showed vertical growth and 96.9% exhibited pleomorphism. A higher proportion of cases with pleomorphism developed metastases at follow-up than those without (60% vs. 12.5%, P=0.026). The present study provides valuable information that could form the basis of future studies in the search for advanced therapy modalities.
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Affiliation(s)
- J Maldonado-Mendoza
- Oral Pathology and Medicine Postgraduate Program, Universidad Autónoma Metropolitana-Xochimilco, Mexico City, Mexico
| | - V Ramírez-Amador
- Oral Pathology and Medicine Postgraduate Program, Universidad Autónoma Metropolitana-Xochimilco, Mexico City, Mexico.
| | - G Anaya-Saavedra
- Oral Pathology and Medicine Postgraduate Program, Universidad Autónoma Metropolitana-Xochimilco, Mexico City, Mexico
| | - M E Irigoyen-Camacho
- Health Care Department, Universidad Autónoma Metropolitana-Xochimilco, Mexico City, Mexico
| | - L Ruíz-Godoy
- Tumour Bank, Instituto Nacional de Cancerología, Mexico City, Mexico
| | - E Ruíz-García
- Translational Research Laboratory, Instituto Nacional de Cancerología, Mexico City, Mexico
| | - A Meneses-García
- Translational Research Laboratory, Instituto Nacional de Cancerología, Mexico City, Mexico
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25
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Soma PF, Pettinato A, Agnone AM, Donia C, Improta G, Fraggetta F. Oral malignant melanoma: A report of two cases with BRAF molecular analysis. Oncol Lett 2014; 8:1283-1286. [PMID: 25120707 PMCID: PMC4114621 DOI: 10.3892/ol.2014.2314] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2013] [Accepted: 06/05/2014] [Indexed: 11/26/2022] Open
Abstract
Primary oral malignant melanoma is a rare condition, accounting for 1.3–1.4% of all melanomas, usually presenting with an aggressive clinical behavior. The present study reports the clinicopathological findings of two cases of oral malignant melanoma and discusses the epidemiology, diagnosis and current therapeutic approaches for this uncommon condition. In the first case the patient presented with a pigmented lesion located on the lower mucosal lip. The patient showed no nodal metastases and therefore, underwent a wedge resection. After seven months, the patient presented with neck lymph nodes and multiple visceral metastases. Molecular analysis of BRAF, using a pyrosequencing approach, revealed the presence of BRAF V600E mutation. The patient developed multiple visceral metastases, but refused treatment and was lost to follow-up. In the second case, no BRAF V600E mutation was found, but the patient exhibited a pigmented patch in the lower gingival mucosa, which was excised by surgical treatment. The patient was followed up by an oncologist, but did not undergo an additional therapy and is currently alive with no evidence of visceral metastases at one year following the diagnosis.
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Affiliation(s)
| | | | | | - Claudio Donia
- Unit of Plastic Surgery, Vittorio Emanuele II Hospital, Castelvetrano (TP) 91022, Italy
| | - Giuseppina Improta
- Laboratory of Clinical Research and Advanced Diagnostics, IRCCS-CROB, Rionero in Vulture (PZ) 85028, Italy
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26
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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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27
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Establishment and characterization of an oral mucosal melanoma cell line (MEMO) derived from a longstanding primary oral melanoma. Am J Dermatopathol 2013; 35:248-51. [PMID: 23249835 DOI: 10.1097/dad.0b013e31826a9905] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Oral mucosal melanoma is rare. Its incidence peaks between 41 and 60 years of age; male/female ratio is 2:1. Preferred oral sites include hard palate and maxillary gingiva. Risk factors have not been clearly identified, but pigmented lesions may be present before the diagnosis of oral melanoma. We report an unusual case of oral mucosal melanoma of long-standing duration on hard palate and maxillary alveolar ridge in a male patient. Histopathologic features confirmed the diagnosis of invasive melanoma with a prominent in situ component. A cell lineage derived from the tumor was established and characterized, with phenotypic markers of melanocytes.
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28
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Lee SW, Kim SG, Park YW, Kweon H, Kim JY, Rotaru H. Cisplatin and 4-hexylresorcinol synergise to decrease metastasis and increase survival rate in an oral mucosal melanoma xenograft model: a preliminary study. Tumour Biol 2013; 34:1595-603. [PMID: 23412976 DOI: 10.1007/s13277-013-0690-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2012] [Accepted: 02/03/2013] [Indexed: 02/03/2023] Open
Abstract
The present study was undertaken to examine the effects of cisplatin plus 4-hexylresorcinol (4-HR) combination therapy on oral mucosal melanoma (OMM) using cultured primary OMM cells in a tumour xenograft model. Cultured primary OMM cells were used for the MTT assay and DNA microarray. OMM cells were implanted into the submandibular glands of nude mice. The mice were then treated with cisplatin only or cisplatin plus 4-HR. Tumour size changes, survival rate and tumour metastasis were compared between the two groups by observation, micro-positron emission tomography (PET) and histological examination. In the MTT assay, the cisplatin plus 4-HR group showed significantly higher inhibition of OMM cell growth compared to the other groups (p<0.05). DNA microarray results showed significant inhibition of matrix metalloproteinase (MMP)-2 gene expression upon 4-HR application. The necropsy and micro-PET results showed that the mice from the cisplatin-only group had more distant metastases than the mice from the cisplatin plus 4-HR combination group (p=0.002). MMP-2 expression was lower in the primary tumours in the cisplatin plus 4-HR combination group than in the cisplatin-only group (p<0.001). Overall survival was longer in mice from the cisplatin plus 4-HR combination group than in the cisplatin-only group (p=0.049). In conclusion, the combined effect of cisplatin and 4-HR resulted in fewer metastases and longer survival than cisplatin-only treatment in the OMM xenograft model.
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Affiliation(s)
- Sang-Woon Lee
- Department of Oral and Maxillofacial Surgery, Gangneung-Wonju National University, College of Dentistry, Gangneung, 210-702, Republic of Korea
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29
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Padhye A, D'souza J. Oral malignant melanoma: A silent killer? J Indian Soc Periodontol 2012; 15:425-8. [PMID: 22368374 PMCID: PMC3283947 DOI: 10.4103/0972-124x.92587] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2011] [Accepted: 11/14/2011] [Indexed: 01/29/2023] Open
Abstract
Oral malignant melanomas are extremely rare lesions and occur commonly in the maxillary gingiva more frequently on the palate with fewer incidences in the mandibular gingiva. Though these lesions are biologically aggressive, they often go unnoticed since they are clinically asymptomatic in the early stages and usually present merely as a hyperpigmented patch on the gingival surface. These lesions if diagnosed at an early in situ stage are potentially curable and definitely have a better prognosis, but unfortunately as they are clinically asymptomatic, it results in delayed diagnosis thus making the prognosis extremely poor. This paper presents the case of a patient who visited our department with the complaint of darkened patches on the gums and his concern was purely aesthetic. There were no symptoms associated with the hyperpigmented lesions and hence the patient did not approach us earlier. When the lesions grew larger and were unsightly, the patient has seeked dental advice. Histopathologic investigation confirmed the diagnosis as ‘Oral Malignant Melanoma’. Though aggressive therapy was instilled immediately, unfortunately, the patient succumbed to death within a few months after diagnosis as the lesion was highly invasive. Due to the biologically aggressive but clinically silent nature of progression of the lesion, the importance of maintaining a high index of suspicion and early detection and diagnosis for any pigmented gingival lesions cannot be overemphasised. Diagnosis must be based on thorough detailed history and valid histologic evidence.
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Affiliation(s)
- Ashvini Padhye
- Department of Periodontology and Oral Implantology, M.A. Rangoonwala College of Dental Sciences and Research Centre, Pune, India
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Primary oral malignant melanoma: two case reports and review of literature. Case Rep Dent 2012; 2012:975358. [PMID: 22900212 PMCID: PMC3414006 DOI: 10.1155/2012/975358] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2012] [Accepted: 06/26/2012] [Indexed: 12/02/2022] Open
Abstract
Primary malignant melanoma of the oral cavity is a rare neoplasm. The tumors tend to metastasize or locally invade tissue more readily than other malignant tumors in the oral region. The survival of patients with mucosal melanomas is less than for those with cutaneous melanomas. Tumor size and metastases are related to the prognosis of the disease. Early detection, therefore, is important.
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de-Andrade BAB, Toral-Rizo VH, León JE, Contreras E, Carlos R, Delgado-Azañero W, Mosqueda-Taylor A, de-Almeida OP. Primary oral melanoma: a histopathological and immunohistochemical study of 22 cases of Latin America. Med Oral Patol Oral Cir Bucal 2012; 17:e383-8. [PMID: 22143732 PMCID: PMC3476096 DOI: 10.4317/medoral.17588] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2011] [Accepted: 05/08/2011] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE The aim of this study was to analyze the histopathological and immunohistochemical characteristics of 22 cases of primary oral melanomas (OM). STUDY DESIGN Twenty two cases of primary oral melanoma were analyzed by description of their histopathological features and immunohistochemical study using the antibodies S-100, HMB-45, Melan-A and Ki-67. RESULTS The mean age was 58 years and 14 cases were female. The main affected sites were the hard palate, followed by the upper gingiva. Microscopically, 15 cases presented level III of invasion, 2 cases were amelanotic and 13 showed a mixed epithelioid and plasmacytoid or spindle cells composition. Some cases showed necrosis, perivascular and perineural invasion. S-100 and HMB-45 were positive in all cases, but 3 cases were negative for Melan-A. The proliferative index with Ki-67 was high, with labeling index ranging from 15.51% to 63% of positive cells. CONCLUSION S-100 and HMB-45 are more frequently expressed than Melan-A in primary oral melanomas and these markers are helpful to confirm the diagnosis.
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Affiliation(s)
- Bruno-Augusto-Benevenuto de-Andrade
- Oral Pathology Section, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, São Paulo, Brazil.
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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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Benevenuto de Andrade BA, Piña AR, León JE, Paes de Almeida O, Altemani A. Primary nasal mucosal melanoma in Brazil: clinicopathologic and immunohistochemical study of 12 patients. Ann Diagn Pathol 2012; 16:344-9. [PMID: 22425483 DOI: 10.1016/j.anndiagpath.2012.02.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2012] [Revised: 01/27/2012] [Accepted: 02/09/2012] [Indexed: 02/03/2023]
Abstract
Primary nasal melanoma is a rare tumor of unknown etiopathogenesis that occurs in adult and elderly patients usually diagnosed at advanced stages. The aim of this study was to analyze the clinicopathologic and immunohistochemical characteristics of 12 cases of primary nasal melanomas in Brazil. Twelve cases of primary nasal melanoma were analyzed histologically and by immunohistochemistry using the antibodies S-100 protein, HMB-45, Melan-A, CD63 (NKI/C3), CD68/KP1, fatty acid synthase (FASN), and Ki-67. The mean age of the patients was 60 years, and 7 of 12 patients were men. Microscopically, 10 cases presented level III of invasion; 4 were amelanotic; and in 7, cells were epithelioid. S-100 protein and FASN were positive in all cases, whereas 9, 8, 7, and 6 cases were positive for HMB-45, Melan-A, CD63 (NKI/C3), and CD68/KP1, respectively. Ki-67 labeling index ranged from 11.45% to 28.5% of positive cells. S-100 protein is more frequently expressed in nasal melanomas than in HMB-45, Melan-A, CD63 (NKI/C3), and CD68/KP1. FASN seems to be involved in the pathogenesis of nasal melanomas, and also, it can be helpful to confirm the diagnosis.
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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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Shen ZY, Liu W, Bao ZX, Zhou ZT, Wang LZ. Oral melanotic macule and primary oral malignant melanoma: epidemiology, location involved, and clinical implications. ACTA ACUST UNITED AC 2011; 112:e21-5. [PMID: 21669356 DOI: 10.1016/j.tripleo.2011.02.040] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2010] [Revised: 02/21/2011] [Accepted: 02/28/2011] [Indexed: 11/16/2022]
Abstract
BACKGROUND Oral malignant melanoma must be differentiated from melanotic macule. STUDY DESIGN Retrospective review of 2 series of oral melanotic macule (n = 52) and oral melanoma (n = 130) were conducted to investigate the epidemiology and location involved and assess their differences. RESULTS The mean age of oral melanotic macule patients was 47.3 years, with female:male ratio 2.1 and the lower lip being the predominant location. The mean age of oral melanoma patients was 53.8 years, with no observed sex predilection and the main locations being palate and gingiva. Differences between the 2 cohorts in age (P = .006), gender (P = .014), and lesion site (P < .001) were noted. In this review, 1 case of oral melanotic macule was found to subsequently develop into melanoma. CONCLUSIONS Oral melanotic macule may possess malignant potential. Biopsy is recommended to differentiate oral melanoma from melanotic macule for male patients >60 years old with suspected melanotic macule lesion located on the palate.
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Affiliation(s)
- Zheng-Yu Shen
- Department of Dermatology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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36
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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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Beier US, Salinas T, Puelacher W. Resection of a primary oral malignant melanoma and rehabilitative management using nasolabial flap: a case report. Oral Maxillofac Surg 2011; 16:141-5. [PMID: 21660434 DOI: 10.1007/s10006-011-0281-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2011] [Accepted: 05/27/2011] [Indexed: 01/20/2023]
Abstract
BACKGROUND The primary malignant melanoma is a rare neoplasm of melanocytic origin in the oral cavity. Only about 1% of all melanomas arise in the oral mucosa and these account for 0.5% of all oral malignancies CASE REPORT This report describes an oral malignant melanoma occurring in the right maxilla of a 73-year-old patient. The interdisciplinary management using a nasolabial flap and prosthetic oral rehabilitation procedure is described. DISCUSSION The nasolabial flap technique offers the possibility of an immediate reconstruction of the maxillary defect and obviated problems with speech, swallowing, and permitted oral intake. As a supplementary benefit, the resection area can support the prosthetic rehabilitation.
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Affiliation(s)
- Ulrike Stephanie Beier
- Clinical Department of Restorative and Prosthetic Dentistry, Innsbruck Medical University, MZA, Anichstrasse 35, 6020 Innsbruck, Austria.
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39
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Fauzdar S, Rao DD, Arthanari KK, Krishnan G, Naikmasur VG, Revanappa MM. Malignant melanoma of the mandibular gingiva. Rare Tumors 2010; 2:e25. [PMID: 21139827 PMCID: PMC2994515 DOI: 10.4081/rt.2010.e25] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2010] [Accepted: 03/24/2010] [Indexed: 11/23/2022] Open
Abstract
Oral malignant melanoma is an infrequent neoplasia making up less than 1% of all melanomas, which exhibits much more aggressive behavior than those found on the skin. We present an aggressive case of oral malignant melanoma located on the mandibular gingiva in a 24-year-old male patient, who developed metastases to not only the regional lymph nodes but also the lungs and liver. The advanced stage of the disease contraindicated any surgical intervention and palliative chemotherapy was planned.
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Oguni A, Umeda M, Shigeta T, Takahashi H, Komori T. The influence of surgical procedure and the effect of chemotherapy on nodal and distant metastases of human malignant melanomas that have been grafted into nude mice. Int J Oral Maxillofac Surg 2009; 39:42-9. [PMID: 19962277 DOI: 10.1016/j.ijom.2009.10.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2009] [Revised: 08/25/2009] [Accepted: 10/12/2009] [Indexed: 11/15/2022]
Abstract
Malignant melanoma of the oral mucosa is common in Japan. The effects on metastasis of puncturing the tumor before surgery or using chemotherapy after extirpation of the tumor were studied using animal models. G-361 cells were transplanted subcutaneously into mice. In half the animals, the subcutaneous tumor was punctured with an 18G needle twice a week from 2 weeks after transplantation until death. In the other mice, the subcutaneous tumor was extirpated 6 weeks after transplantation; the animals were killed 2 weeks later. Dimethyl triazeno imidazole carboxamide (DTIC) or cisplatin (CDDP) were injected into the peritoneal cavity 3 days before extirpation or during extirpation. Metastases to the axilla lymph node and the lung were examined in both groups. The animals that received puncturing developed lymph node and pulmonary metastasis earlier and more frequently than those without puncturing. 50% of mice that received no anticancer agent, had lymph node and pulmonary metastases after tumor extirpation. Preoperative DTIC or CDDP reduced the frequency of metastasis to 25-35%. DTIC or CDDP administration during extirpation, significantly reduced the metastasis rate to 7-10%. Prognosis for oral melanoma patients may be better when surgery and postoperative chemotherapy are performed simultaneously without preoperative surgical procedures.
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Affiliation(s)
- A Oguni
- Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, Japan.
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Abstract
Oral mucosal melanoma is rare and reported to be more aggressive than its cutaneous counterpart. Due to the rarity of this entity, data on epidemiology, tumor behavior, treatment, follow-up, and survival of patients are mainly based on single case reports. The few existing series of patients show that oral mucosa melanoma has its peak between 41 and 60 years of age, and male to female ratio is 2:1. Preferred oral sites include hard palate and maxillary alveolar crests. Risk factors have not been clearly identified, and surgical treatment is still the treatment of choice for oral mucosal melanomas. The authors retrospectively studied 35 patients with primary melanoma of the oral cavity to report their clinical and pathological features, such as age, sex, site of the tumor, metastasis, treatment, response to therapy, and outcome. We found no significant sex predominance, and the mean age of the patients was 60.6 years, with a range from 9 to 91 years. The majority of the patients (71.42%) had palate commitment, and invasive histopathological aspect was observed in 80% of the specimens (grade 3). Long-distance metastasis was found in 60% of the cases. Fourteen patients were submitted to wide surgical resections, with local relapse being observed in 11 of them (78.5%). The authors suggest that improved outcome in oral malignant melanoma requires the development of new therapies and the prevention of distant metastasis.
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42
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Ulcerated pedunculated mass of the maxillary gingiva. ACTA ACUST UNITED AC 2009; 108:313-7. [PMID: 19589701 DOI: 10.1016/j.tripleo.2009.05.019] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2007] [Revised: 04/16/2009] [Accepted: 05/25/2009] [Indexed: 01/30/2023]
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43
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Sortino-Rachou AM, Cancela MDC, Voti L, Curado MP. Primary oral melanoma: Population-based incidence. Oral Oncol 2009; 45:254-8. [DOI: 10.1016/j.oraloncology.2008.04.015] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2008] [Revised: 04/02/2008] [Accepted: 04/25/2008] [Indexed: 01/23/2023]
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44
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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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Umeda M, Komatsubara H, Shigeta T, Ojima Y, Minamikawa T, Shibuya Y, Yokoo S, Komori T. Treatment and prognosis of malignant melanoma of the oral cavity: preoperative surgical procedure increases risk of distant metastasis. ACTA ACUST UNITED AC 2008; 106:51-7. [PMID: 18504155 DOI: 10.1016/j.tripleo.2008.03.003] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2007] [Revised: 02/01/2008] [Accepted: 03/05/2008] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Many authors have reported that oral melanoma patients showed much worse prognosis than those with cutaneous melanoma. We investigated treatment method and prognosis of patients with oral malignant melanoma. STUDY DESIGN Twenty-one patients with oral melanoma treated at our hospital were investigated, with special reference to the influence of preoperative surgical procedures such as biopsy, incision, or tooth extraction on the prognosis. RESULTS All patients underwent surgery followed by immuno-chemotherapy with dimethyl triazeno imidazole carboxamide (DTIC), ninustine hydrochloride (ACNU), vincristine (VCR), and biologic response modifier OK-432. Local control was obtained in 20 of 21 patients. Lymph node metastasis appeared in 13 patients, but neck failure was not detected in any patients. Distant metastasis occurred in 9 patients in spite of loco-regional control. Five-year survival rate of 12 patients with no preoperative surgical procedure was 91.7%, while that of the 9 patients who had undergone surgical procedures before treatment was 25.9% (P < .05). CONCLUSIONS Oral melanoma patients can obtain a prognosis as good as that for cutaneous melanoma patients, when the above-mentioned therapy is used without any preoperative surgical procedures.
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Affiliation(s)
- Masahiro Umeda
- Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.
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Chidzonga MM, Mahomva L, Marimo C, Makunike-Mutasa R. Primary Malignant Melanoma of the Oral Mucosa. J Oral Maxillofac Surg 2007; 65:1117-20. [PMID: 17517294 DOI: 10.1016/j.joms.2006.11.045] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2005] [Revised: 11/06/2006] [Accepted: 11/15/2006] [Indexed: 11/19/2022]
Abstract
PURPOSE To present our experience on the epidemiology, clinical features, management, and survival of patients with oral malignant melanoma. PATIENTS AND METHODS Records of patients with a histologic diagnosis of primary oral mucosal malignant melanoma seen over a 23-year period were retrospectively reviewed. RESULTS There were 6 females and 2 males, ranging in age from 18 to 60 years; 4 cases in the maxilla, 2 in the mandible, 1 on the lower lip, and 1 on the buccal mucosa. Local recurrences developed in 2 patients who eventually died with clinical metastatic cervical nodal disease. Follow-up ranged from 6 months to 16 years 3 months. Surgery was the only treatment available. CONCLUSION Primary oral mucosal melanoma is rare, with a 3 to 1 female to male ratio and an average age of 41.7 years at presentation. It is most common in the maxilla and has poor prognosis despite apparent adequate local surgical control.
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Affiliation(s)
- Midion Mapfumo Chidzonga
- Oral and Maxillofacial Surgeon, Department of Dentistry, College of Health Sciences, University of Zimbabwe, Avondale Harare, Zimbabwe.
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Symvoulakis EK, Kyrmizakis DE, Drivas EI, Koutsopoulos AV, Malandrakis SG, Skoulakis CE, Bizakis JG. Oral mucosal melanoma: a malignant trap. Head Face Med 2006; 2:7. [PMID: 16569245 PMCID: PMC1475844 DOI: 10.1186/1746-160x-2-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2006] [Accepted: 03/28/2006] [Indexed: 11/17/2022] Open
Abstract
Oral mucosal melanomas are highly malignant tumors. 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. We present the case of a 75-year-old man who was referred to the Ear, Nose and Throat department. His symptoms were voice alteration and saliva drooling, progressively worsening during the last few weeks. The absence of pain was the reason for the delay of seeking medical care. The diagnosis was an oversized oral melanoma. This is an example of how the time of diagnosis and the evolution of a disease could be seriously influenced by patient's behavior. Melanomas arising from oral mucosa have poor prognosis unless they are discovered and treated early. The vigilance of the physicians is necessary to have success in this difficult task.
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Affiliation(s)
- Emmanouil K Symvoulakis
- Department of Otorhinolaryngology, University of Crete School of Medicine, Heraklion, Crete, Greece
| | - Dionysios E Kyrmizakis
- Department of Otorhinolaryngology, University of Crete School of Medicine, Heraklion, Crete, Greece
| | - Emmanouil I Drivas
- Department of Otorhinolaryngology, University of Crete School of Medicine, Heraklion, Crete, Greece
| | | | - Stylianos G Malandrakis
- Department of Otorhinolaryngology, University of Crete School of Medicine, Heraklion, Crete, Greece
| | - Charalambos E Skoulakis
- Department of Otorhinolaryngology, University of Crete School of Medicine, Heraklion, Crete, Greece
| | - John G Bizakis
- Department of Otorhinolaryngology, University of Crete School of Medicine, Heraklion, Crete, Greece
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Perrotti V, Piattelli A, Rubini C, Fioroni M, Petrone G. Malignant melanoma of the maxillary gingiva: a case report. J Periodontol 2005; 75:1724-7. [PMID: 15732878 DOI: 10.1902/jop.2004.75.12.1724] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Mucosal malignant melanoma of the of the head and neck is a rare neoplasm, accounting for about 0.2% of all melanomas. We present the clinopathological findings of a case. METHODS An 83-year-old woman presented with a dark reddish pigmented lesion which had appeared 3 years previously. RESULTS Clinical examination revealed a sessile lesion, 1.5 cm in diameter, located on the vestibular maxillary gingiva next to the first molar area. Microscopic analysis of the neoplasm showed epithelioid cells with prominent nucleoli aggregated in solid nests. Cytoplasmic melanin pigmentation was present. The neoplastic cells were positive for HMB-45 and S100 protein. The final histologic diagnosis was primary malignant melanoma of the gingiva. Physical examination and a computerized tomography scan of the neck, liver, and lungs ruled out the possibility of occult melanoma lesions elsewhere in the body. CONCLUSION The prognosis for patients with oral malignant melanoma is extremely poor. Earlier recognition of this condition simplifies treatment and greatly improves the prognosis for these patients.
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Kawahara K, Lee YJ, Nagatsuka H, Rui K, Auerkari EI, Floresca MCGZ, Kishikawa H, Nagai N. A Study of Eight Oral Malignant Melanoma in Adults by WESTOP (Western Society of Teachers of Oral Pathology, 1995). J HARD TISSUE BIOL 2005. [DOI: 10.2485/jhtb.14.122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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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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