Wagner Vivian Petersen, Munhoz Etiene Andrade, Carrard Vinicius Coelho, de Oliveira Marcia Gaiger, Rados Pantelis Varvaki, Filho Manoel Santa'ana
Gen Dent. 2013 Sep-Oct;61(6):e2-5.
Pigmentations of the oral mucosa include a range of lesions or conditions that manifest as changes in the color of oral tissues; these changes may show melanocytic activity. A melanotic macule is a small, well-circumscribed melanocytic benign lesion. It can occur on the lips and intraorally and ranges in color from brown to black. Microscopically, it is characterized by elevated levels of melanin production by basal melanocytes, which appear normal in terms of number, morphology, and distribution. A 48-year-old woman sought treatment for a pigmented lesion that had been present for 4 months. Intraoral examination revealed a non-homogenous brownish spot (measuring 0.7 cm) with irregular borders on the left side of the soft palate. Since the lesion had an atypical clinical appearance, melanocytic nevus, oral melanoacanthoma, and oral malignant melanoma were considered in differential diagnoses. After an incisional biopsy, the lesion was diagnosed as a melanotic macule. Due to their varying clinical appearance, benign pigmented lesions can be mistaken for malignant tumors, especially when the lesions exhibit similar coloration, symmetry, and borders. Through this report on a case with atypical clinical characteristics, we aim to reinforce the ubiquitous nature of oral pigmented lesions, and the importance of employing different approaches to diagnosing these lesions.
口腔黏膜色素沉着包括一系列表现为口腔组织颜色改变的病变或状况；这些改变可能显示黑素细胞活性。黑素斑是一种小的、边界清晰的黑素细胞良性病变。它可发生于唇部和口腔内，颜色从棕色到黑色不等。显微镜下，其特征是基底黑素细胞产生的黑色素水平升高，这些黑素细胞在数量、形态和分布方面看起来正常。一名48岁女性因一个已存在4个月的色素沉着病变前来就诊。口腔检查发现软腭左侧有一个边界不规则的不均匀褐色斑点（大小为0.7厘米）。由于该病变具有非典型的临床表现，鉴别诊断时考虑了黑素细胞痣、口腔黑素棘皮瘤和口腔恶性黑色素瘤。经切开活检后，该病变被诊断为黑素斑。由于其临床表现各异，良性色素沉着病变可能被误诊为恶性肿瘤，尤其是当病变表现出相似的颜色、对称性和边界时。通过这份关于具有非典型临床特征病例的报告，我们旨在强调口腔色素沉着病变的普遍性，以及采用不同方法诊断这些病变的重要性。
