Motiee-Langroudi Maziar, Farahzadi Athena, Aminshakib Pouyan
Imam Khomeini Complex Hospital, Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran.
Division of Surgical Oncology, Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran.
Cancer Rep (Hoboken). 2025 May;8(5):e70215. doi: 10.1002/cnr2.70215.
Melanoma of the oral mucosa is an uncommon cancer arising from the tissues lining the mouth. Among oronasal malignant melanomas, tongue melanoma makes up a mere 2%. Optimal treatments for this rare and often late-stage disease remain elusive. However, surgery with free margins is considered the primary treatment and is often combined with other therapies such as neck dissection, adjuvant radiotherapy, chemotherapy, and immunotherapy.
This case involves a 33-year-old woman with a history of malignant melanoma on her tongue. She had previously undergone a partial glossectomy and was on maintenance imatinib treatment for ~2 years. During her follow-up, a new lesion was discovered on her tongue, which was confirmed to be malignant melanoma and was resected. The tumor exhibited a depth of invasion of 8 mm. All surgical margins were clear, with the closest margin being 3 mm. The lesion was reconstructed with a submental flap. Adjuvant radiotherapy was also given. The patient has been on maintenance follow-up for 3 years with no signs of recurrence.
Malignant melanoma should be considered in the differential diagnosis of pigmented and non-pigmented lesions of the tongue and oral mucosa. A thorough clinical evaluation, followed by histopathological and immunohistochemical examination of any suspicious lesions, is essential for early diagnosis. Early detection and prompt treatment are crucial for optimizing patient outcomes and improving survival rates.
口腔黏膜黑色素瘤是一种起源于口腔内衬组织的罕见癌症。在口鼻部恶性黑色素瘤中，舌部黑色素瘤仅占2%。对于这种罕见且通常处于晚期的疾病，最佳治疗方法仍不明确。然而，切缘阴性的手术被认为是主要治疗方法，且常与其他疗法联合使用，如颈部清扫术、辅助放疗、化疗和免疫疗法。
本病例涉及一名33岁女性，有舌部恶性黑色素瘤病史。她之前接受过部分舌切除术，并接受了约2年的伊马替尼维持治疗。在随访期间，她的舌部发现了一个新病变，经证实为恶性黑色素瘤并进行了切除。肿瘤浸润深度为8毫米。所有手术切缘均为阴性，最接近的切缘为3毫米。采用颏下皮瓣进行缺损修复。患者还接受了辅助放疗。患者已接受3年的维持随访，无复发迹象。
在舌部和口腔黏膜色素沉着及非色素沉着病变的鉴别诊断中应考虑恶性黑色素瘤。进行全面的临床评估，随后对任何可疑病变进行组织病理学和免疫组织化学检查，对于早期诊断至关重要。早期发现和及时治疗对于优化患者预后和提高生存率至关重要。
