Sil Shiladitya, Pyne Rudra, Ghosh Subhankar, Saha Nilanjana
Department of Oral Medicine and Radiology, North Bengal Dental College and Hospital, Darjeeling, West Bengal, India.
Department of Oral and Maxillofacial Pathology, Dr R Ahmed Dental College and Hospital, Kolkata, West Bengal, India.
J Family Med Prim Care. 2025 Mar;14(3):1147-1151. doi: 10.4103/jfmpc.jfmpc_1672_24. Epub 2025 Mar 25.
Oral melanotic macules and primary oral malignant melanoma are distinct pigmented lesions that can present clinical challenges in diagnosis. While melanotic macules are generally benign, quite a few instances of progression to melanoma have been reported. We present the case of a 42-year-old female with gradually enlarging painless pigmented macules on her lips, diagnosed as oral melanotic macules after histopathological evaluation. Although no signs of melanocytic hyperplasia or dysplasia were found, the patient was closely monitored due to the lesion's increasing size over 3 months. This case highlights the importance of distinguishing between benign pigmented lesions, which have a propensity to undergo malignant transformation from those that show no such tendency. Presences of histopathological features like atypical melanocytes and melanocytic hyperplasia/dysplasia in benign pigmented lesions are important markers for malignant transformation. Close clinical follow-up is essential to ensure timely intervention if the lesion exhibits suspicious changes.
口腔黑色素沉着斑和原发性口腔恶性黑色素瘤是不同的色素沉着性病变,在诊断上可能带来临床挑战。虽然黑色素沉着斑一般为良性,但已有不少进展为黑色素瘤的病例报道。我们报告一例42岁女性,其唇部有逐渐增大的无痛性色素沉着斑,经组织病理学评估诊断为口腔黑色素沉着斑。尽管未发现黑素细胞增生或发育异常的迹象,但由于病变在3个月内不断增大,对该患者进行了密切监测。本病例强调了区分良性色素沉着性病变(有恶变倾向)与无此倾向病变的重要性。良性色素沉着性病变中存在非典型黑素细胞和黑素细胞增生/发育异常等组织病理学特征是恶变的重要标志。如果病变出现可疑变化,密切的临床随访对于确保及时干预至关重要。