Maxillofacial Surgery Department, University Hospital Center Mohammed VI, Marrakesh, Morocco.
Department of Otorhinolaryngology, University Hospital Center Mohammed VI, Marrakesh, Morocco.
Pan Afr Med J. 2020 Dec 16;37:350. doi: 10.11604/pamj.2020.37.350.27330. eCollection 2020.
Amelanotic malignant melanoma is an extremely rare and aggressive oral tumor. Herein we report the case of a 42-year-old woman presented with a painful growth in anterior maxillary region. Intra-oral examination showed a non-pigmented exophytic mass occupying the anterior maxillary sector. Incisional biopsy with immunohistochemistry examination revealed a malignant melanoma as it strongly expressed melan A and S-100. Facial computed tomography showed extension to the maxillary bone and hard palate. After thoraco-abdominal computed tomography revealing absence of metastasis, tumor resection was performed respecting 2cm security margin. Oral localization of malignant melanoma is rare especially its amelanotic variant. Lack of pigmentation makes the diagnosis more difficult, usually resulting in treatment delay and making the prognosis even worse. Early detection by histological and immunochemistry examination combined to wide resection are the keys to improving the survival for patients with oral amelanotic melanoma.
无色素恶性黑色素瘤是一种极为罕见且侵袭性强的口腔肿瘤。本文报告了 1 例 42 岁女性,其因前上颌区疼痛性生长就诊。口腔检查显示前上颌区有一无色素的外生性肿块。切开活检结合免疫组化检查显示为恶性黑色素瘤,因为其强烈表达黑色素 A 和 S-100。面骨 CT 显示肿瘤侵犯上颌骨和硬腭。胸腹部 CT 未见转移后,行肿瘤切除术,切缘安全距离 2cm。口腔恶性黑色素瘤的发生部位罕见,特别是无色素型。缺乏色素使诊断更加困难,通常导致治疗延误,预后更差。通过组织学和免疫化学检查结合广泛切除的早期发现是改善口腔无色素性黑色素瘤患者生存的关键。