J Am Dent Assoc. 2017 Feb;148(2):113-119. doi: 10.1016/j.adaj.2016.10.005. Epub 2016 Nov 9.
Oral melanomas vary in color and morphology and resemble myriad other reactive, benign, or malignant conditions. The authors describe a case report of a patient with a primary oral melanoma that presented as a nonspecific ulcer, which showed nodal metastasis during resection.
A 64-year-old man who was examined by his periodontist to assess implant healing had a reddish-purple ulcer of the maxillary mucosa of 3 to 4 weeks duration. The implant was placed 19 weeks earlier in the mandible. The provisional diagnosis was that this ulcer was a traumatic or inflammatory lesion. The clinician biopsied the tissue at the 1-week follow-up appointment, which was identified as melanoma. The patient had a partial maxillectomy and ipsilateral neck dissection. Tissue examination showed nodal metastasis. Two months later, contralateral neck node metastasis was diagnosed and treated.
In contrast to cutaneous melanoma, oral melanoma has a poor prognosis because of delayed diagnosis. Thorough oral examination at each dental visit may improve the outcome of this fatal condition.
口腔黑色素瘤在颜色和形态上存在差异，类似于其他多种反应性、良性或恶性疾病。作者描述了一例以非特异性溃疡为表现的原发性口腔黑色素瘤患者病例报告，该患者在切除时出现了淋巴结转移。
一名 64 岁男性因评估种植体愈合情况而接受牙周病医生检查，他的上颌黏膜出现了 3 至 4 周的红紫色溃疡。19 周前在下颌植入了种植体。初步诊断为该溃疡是创伤性或炎症性病变。临床医生在 1 周的随访预约时对组织进行了活检，结果确定为黑色素瘤。患者接受了上颌骨部分切除术和同侧颈部淋巴结清扫术。组织检查显示淋巴结转移。两个月后，诊断并治疗了对侧颈部淋巴结转移。
与皮肤黑色素瘤不同，口腔黑色素瘤由于诊断延迟，预后较差。在每次牙科就诊时进行彻底的口腔检查可能会改善这种致命疾病的预后。
