Oral malignant melanoma: An aggressive clinical entity - Report of a rare case with review of literature

Primary amelanotic malignant melanoma of parotid and submandibular salivary gland: A rare case report

Primary amelanotic malignant melanomas (AMMs) of the parotid and submandibular salivary glands are extremely rare with only a few reported cases due to its low incidence and misdiagnosis. Malignant melanoma (MM) has a high predilection for the head-and-neck region and majority of the cases in the parotid gland reported as association with metastasis in and around the gland from a cutaneous primary tumor. Immunohistochemistry is solely needed for confirmation of diagnosis and MMs give positive reactivity for melan-A, HMB-45, and S-100. Prognosis for AMM in the mucosal or salivary gland regions is much poorer than cutaneous regions because of anatomic considerations and its delayed diagnosis. The treatment of choice is radical surgery and parotidectomy along with radiotherapy and chemotherapy.

Treatment Modalities of Recurrent Oral Mucosal Melanoma In Situ

Oral mucosal melanoma (OMM) represents an extremely rare entity that is associated with a poor prognosis due to late diagnosis and early metastasis. Here, extensive surgical therapy is the therapy of choice. In contrary, for OMM in situ, the respective therapeutical recommendations are lacking. In this case report, treatment modalities of an OMM in situ of the palate, including the maxillary alveolar process, are reported. The tumor relapsed twice despite adequate surgical therapy and reconstruction. Therefore, irradiation was performed as an adjuvant therapy. At a follow-up of two years, the patient was free from recurrences.

Metastatic malignant melanoma of unknown primary in temporalis muscle

Metastatic melanoma of unknown primary (MUP) is an uncommon melanocytic lesion found in distant sites with no evident skin involvement. This case report presents a 75-year-old woman who underwent local excision for a lump in the right temporal area, which had been present for 6 months and had been suspected to be a lipoma. Histology confirmed that the tissue excised from the temporalis muscle was composed of atypical, heavily pigmented melanocytes. Her history was negative for melanocytic lesions, and examination and extensive investigation including imaging had failed to identify a primary lesion. The patient is currently being followed up.

Oral malignant melanoma

Malignant melanoma in the head and neck area is rare. The incidence of oral malignant melanomas of the head and neck is approximately four per 10 million populations per year. They are derived from epidermal melanocytes and are most frequently seen on the palate and maxillary gingiva. They are asymptomatic initially but become painful with progress and enlargement. Later, they are associated with ulceration, bleeding, mobility of tooth, paresthesia and ill-fitting prosthesis. The diagnosis is often delayed due to silent growth and development of the lesion. Oral malignant melanomas are associated with poor prognosis due to their invasive and metastasizing tendencies. This case report is presented to emphasize the role of a dentist in identifying the pigmented lesions of the oral cavity.