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. 2012 May 1;17(3):e383-8.
doi: 10.4317/medoral.17588.

Primary oral melanoma: a histopathological and immunohistochemical study of 22 cases of Latin America

Bruno-Augusto-Benevenuto de-Andrade  1 , Víctor-Hugo Toral-Rizo, Jorge-Esquiche León, Elisa Contreras, Román Carlos, Wilson Delgado-Azañero, Adalberto Mosqueda-Taylor, Oslei-Paes de-Almeida
Affiliations

Primary oral melanoma: a histopathological and immunohistochemical study of 22 cases of Latin America

Bruno-Augusto-Benevenuto de-Andrade et al. Med Oral Patol Oral Cir Bucal. .

Abstract

Objective: The aim of this study was to analyze the histopathological and immunohistochemical characteristics of 22 cases of primary oral melanomas (OM).

Study design: Twenty two cases of primary oral melanoma were analyzed by description of their histopathological features and immunohistochemical study using the antibodies S-100, HMB-45, Melan-A and Ki-67.

Results: The mean age was 58 years and 14 cases were female. The main affected sites were the hard palate, followed by the upper gingiva. Microscopically, 15 cases presented level III of invasion, 2 cases were amelanotic and 13 showed a mixed epithelioid and plasmacytoid or spindle cells composition. Some cases showed necrosis, perivascular and perineural invasion. S-100 and HMB-45 were positive in all cases, but 3 cases were negative for Melan-A. The proliferative index with Ki-67 was high, with labeling index ranging from 15.51% to 63% of positive cells.

Conclusion: S-100 and HMB-45 are more frequently expressed than Melan-A in primary oral melanomas and these markers are helpful to confirm the diagnosis.

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Figures

Figure 1
Figure 1
Clinical aspects of primary oral melanoma. A. Oral melanoma of the hard palate showing a large black, irregular macula with a small nodular area. B. Large pigmented melanoma of the lower gingiva causing tooth displacement.
Figure 2
Figure 2
Histological aspects of primary oral melanoma (H&E). A. Oral melanoma of the hard palate composed mainly by amelanotic spindle cells (x200). B. Oral melanoma of the upper gingiva formed by epithelioid and plasmacytoid neoplastic melanocytes (x400). C. Solid OM showing nodular pattern of neoplastic melanocytic cells (x25). D. Epithelioid and plasmacytoid neoplastic melanocytes arranged in organoid pattern (x100). E. In situ lesion with neoplastic melanocytes arranged in pagetoid pattern (x100). F. Oral melanoma of the hard palate showing perivascular invasion (x400).
Figure 3
Figure 3
Expression of S-100 (A), HMB-45 (B), Melan-A (C), and Ki-67 (D) in primary oral melanoma of hard palate and upper gingiva (x400).
See this image and copyright information in PMC

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