Perrotti Vittoria, Piattelli Adriano, Rubini Corrado, Fioroni Massimiliano, Petrone Giovanna
Dental School, University of Chieti, Chieti, Italy.
J Periodontol. 2004 Dec;75(12):1724-7. doi: 10.1902/jop.2004.75.12.1724.
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.
An 83-year-old woman presented with a dark reddish pigmented lesion which had appeared 3 years previously.
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.
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.
头颈部黏膜恶性黑色素瘤是一种罕见的肿瘤,约占所有黑色素瘤的0.2%。我们报告一例的临床病理结果。
一名83岁女性患者出现一个暗红色色素沉着病变,该病变于3年前出现。
临床检查发现一个直径1.5 cm的无蒂病变,位于第一磨牙区旁的上颌前庭牙龈。肿瘤的显微镜分析显示上皮样细胞,核仁突出,聚集成实性巢状。存在细胞质黑色素沉着。肿瘤细胞HMB-45和S100蛋白呈阳性。最终组织学诊断为牙龈原发性恶性黑色素瘤。体格检查以及颈部、肝脏和肺部的计算机断层扫描排除了身体其他部位隐匿性黑色素瘤病变的可能性。
口腔恶性黑色素瘤患者的预后极差。早期识别这种情况可简化治疗并大大改善这些患者的预后。