Department of Oral and Maxillofacial Surgery, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Faculty of Dentistry, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran.
BMC Oral Health. 2022 Aug 14;22(1):351. doi: 10.1186/s12903-022-02380-2.
Cutaneous melanomas account for more than 95% of all cases of primary melanoma, making non-cutaneous primary melanomas truly rare. Cases of primary mucosal melanomas of the oral cavity have been widely described; however, instances of primary melanomas arising from salivary glands have been rarely described. To date, this is only the second case of primary melanoma of the submandibular gland.
This is a report of a case of a 36-year-old healthy male patient, who was referred to us with the chief complaint of a growing swelling on the left side of his lower jaw. Evaluations revealed an evident facial asymmetry in the frontal view with a firm, non-tender swelling. Initial orthopantomogram did not reveal any alterations in the trabeculation or morphology of the jaws and the surrounding structures. A soft tissue ultrasonography of the left submandibular gland and anterior region of mandible revealed a hypoechoic cystic mass with numerous micro-echoes. Further para-clinical examinations yielded the definitive diagnosis of primary melanoma of the submandibular gland. Moreover, no evidence of distant osteometastasis was observed in whole-body scans. Subsequent surgical management with the approach of excising the submandibular salivary gland and concurrent selective neck dissection was implemented.
This report emphasizes the importance of thorough examination and prompt referral to designated specialists in cases with suspicious behaviors which are unresponsive to treatments. It can be further concluded that melanoma can mimic a range of benign pathologies; therefore, putting it in the list differential diagnosis of similar lesions seems plausible.
皮肤黑色素瘤占原发性黑色素瘤的 95%以上，因此非皮肤原发性黑色素瘤非常罕见。口腔原发性黏膜黑色素瘤已有广泛描述；然而，发生于唾液腺的原发性黑色素瘤则很少见。迄今为止，这仅是第二例下颌下腺原发性黑色素瘤。
这是一例 36 岁健康男性患者的病例报告，因左侧下颌逐渐肿胀来我院就诊。评估显示正面观明显面部不对称，有一个坚实、无触痛的肿胀。初始全景片未显示颌骨及其周围结构的小梁和形态有任何改变。左侧下颌下腺和下颌前区的软组织超声显示一个低回声囊性肿块，有许多微小回声。进一步的辅助检查得出了原发性下颌下腺黑色素瘤的明确诊断。此外，全身扫描未发现远处骨转移的证据。随后采用切除下颌下腺和选择性颈部淋巴结清扫术的方法进行了手术治疗。
本报告强调了在可疑行为且对治疗无反应的情况下进行彻底检查和及时转介给指定专家的重要性。可以进一步得出结论，黑色素瘤可以模仿一系列良性病变；因此，将其列入类似病变的鉴别诊断清单似乎是合理的。
