Oral malignant melanoma: A case report of an unusual clinical and histologic presentation

Abstract

Malignant melanoma is a potentially aggressive tumor of melanocytic origin. Primary oral malignant melanoma is a rare neoplasm, accounting for 0.5% of all oral malignancies. The present case occurred in a 60-year-old female patient, as a pedunculated growth involving the palate and alveolar ridge and histologically showing a desmoplastic differentiation. The article discusses the distinct clinico-pathologic presentation of this case and emphasizes on the need to identify and report such cases for further understanding of their biologic behavior.

Keywords: Desmoplastic melanoma; malignant melanoma; oral mucosal melanoma.

Figure 1

Clinical picture showing a pedunculated lesion involving the palate

Figure 2

Computed tomography image showing subtle bony erosion noted over the mid portion of the hard palate

Figure 3

Superficial dermis showing pigmented epitheloid and spindle tumor cells (H and E, ×40)

Figure 4

Deep dermis showing the tumor with predominant spindle cell type arranged in irregular branching pattern with intervening fibrous septae (H and E, ×10)

Figure 5

Spindle tumor cells appear fusiform to rounded in different orientations (H and E, ×40)

Figure 6

Tumor cells showing atypical features like mitosis, pleomorphism, hyperchromatism, increased nuclear cytoplasmic ratio and prominent nucleoli (H and E, ×40)