Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, São Paulo, Brazil.
Head and neck surgeon, Private office, Piracicaba, Sâo Paulo, Brazil, Piracicaba, Brazil.
Spec Care Dentist. 2024 May-Jun;44(3):751-755. doi: 10.1111/scd.12928. Epub 2023 Oct 9.
Primary oral mucosal melanoma (OMM) represents an extremely rare and aggressive tumor that arises from malignant transformation and clonal expansion of melanocytes in the oral cavity. The prognosis of patients affected by OMM is quite unfavorable, with survival rates lower than those described for patients with cutaneous melanoma.
Here, we report a case of OMM in a 59-year-old Caucasian woman, who was referred for evaluation of a large asymptomatic pigmented lesion on the left side of the hard palate under the removable total denture. Incisional biopsy was performed, and histopathological analysis revealed the proliferation of spindle-shaped and pigmented epithelioid cells, with cellular pleomorphism. These cells were positive for Melan A, S-100, HMB-45, SOX-10, and Ki-67 confirming the diagnosis of OMM. The patient underwent partial maxillectomy and adjuvant radiotherapy. After treatment, she was rehabilitated with a palatal obturator prosthesis and has been in follow-up for 10 years with no evidence of disease. Due to the rarity in the oral cavity and the nonspecific signs and symptoms, the diagnosis of OMM is difficult and often overlooked.
Therefore, multidisciplinary management from diagnosis, treatment, and rehabilitation is important to increase the expectation of cure.
原发性口腔黏膜黑色素瘤（OMM）是一种极为罕见且侵袭性的肿瘤，起源于口腔内黑色素细胞的恶性转化和克隆性扩张。受 OMM 影响的患者的预后相当不利，生存率低于皮肤黑色素瘤患者。
在这里，我们报告了一例 59 岁白人女性的 OMM 病例，她因在活动式全口义齿下左侧硬腭的一个大无症状色素性病变而被转诊评估。进行了切开活检，组织病理学分析显示梭形和色素上皮样细胞的增殖，具有细胞多形性。这些细胞对 Melan A、S-100、HMB-45、SOX-10 和 Ki-67 呈阳性，证实了 OMM 的诊断。患者接受了部分上颌骨切除术和辅助放疗。治疗后，她使用腭护板义齿进行了康复，并在 10 年的随访中没有疾病迹象。由于口腔内罕见且症状无特异性，OMM 的诊断困难且常常被忽视。
因此，从诊断、治疗和康复方面进行多学科管理对于提高治愈期望很重要。
