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Case Reports
. 2020 Jun 22;10(6):424.
doi: 10.3390/diagnostics10060424.

Multifocal Amelanotic Melanoma of the Hard Palate: A Challenging Case

Luisa Limongelli  1 , Eliano Cascardi  2 , Saverio Capodiferro  1 , Gianfranco Favia  1 , Massimo Corsalini  1 , Angela Tempesta  1 , Eugenio Maiorano  2
Affiliations
Case Reports

Multifocal Amelanotic Melanoma of the Hard Palate: A Challenging Case

Luisa Limongelli et al. Diagnostics (Basel). .

Abstract

Among all melanomas, the mucosal type is very rare and may occur in the sino-nasal mucosa, vagina, anus and the oral cavity. At variance with melanomas of the skin, no risk factors, such as familiarity, UV-exposure and skin phenotype, have been clearly identified for such neoplasms. Frequently, the diagnosis is delayed and achieved at advanced stages or when metastases have already occurred. The authors report on a case of mucosal melanoma of the oral cavity presenting as a mass of the hard palate in a 50-year old male, and the corresponding diagnostic-therapeutic pathway.

Keywords: head and neck; melanoma; mucosal melanoma; oral tumors.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Rapidly growing lesion of the hard palate with periodontal involvement, with a red-yellowish appearance.
Figure 2
Figure 2
Panoramic radiogram showing an osteolytic lesion of the left anterior maxilla with undefined borders, involving the periodontal ligament of 2.1 and 2.4 as well as the retained 2.3 tooth.
Figure 3
Figure 3
Sagittal computed tomography showing the extension of the lesion, with erosion of the hard palate and involvement of the maxillary sinus up to the orbital base.
Figure 4
Figure 4
Low power view of a poorly demarcated lesion, located in the upper lamina propria (Hematoxylin & Eosin, ×2).
Figure 5
Figure 5
The tumor cells are epithelioid in shape, amelanotic and arranged in nests or nodules (Hematoxylin & Eosin, ×20).
Figure 6
Figure 6
The neoplastic cells are strongly and diffusely immunoreactive for S-100 protein (a) (×2) and cytokeratins (with a dot-like pattern) (b) (×20), but negative for HMB-45 (c) (×2) as well as for Melan-A (not shown).
Figure 6
Figure 6
The neoplastic cells are strongly and diffusely immunoreactive for S-100 protein (a) (×2) and cytokeratins (with a dot-like pattern) (b) (×20), but negative for HMB-45 (c) (×2) as well as for Melan-A (not shown).
Figure 7
Figure 7
In this lesion, still located in the upper lamina propria, the tumor cells are filled with melanin pigment (a) (Hematoxylin & Eosin, ×2), and show consistent HMB-45 immunoreactivity (b) (×20).
Figure 8
Figure 8
Post-operative defect of the palate with residual perforation: (a) receiving an obturator prosthesis (b) to improve chewing and protect airways (c).
See this image and copyright information in PMC

References

    1. Yde S.S., Sjoegren P., Heje M., Stolle L.B. Mucosal melanoma: A literature review. Curr. Oncol. Rep. 2018;20:28. doi: 10.1007/s11912-018-0675-0. - DOI - PubMed
    1. Ascierto P.A., Accorona R., Botti G., Farina D., Fossati P., Gatta G., Gogas H., Lombardi D., Maroldi R., Nicolai P. Mucosal melanoma of the head and neck. Crit. Rev. Oncol. Hematol. 2017;112:136–152. doi: 10.1016/j.critrevonc.2017.01.019. - DOI - PubMed
    1. Crowson A.N., Magro C.M., Sanchez-Carpintero I., Mihm M.C. Cancers of the Skin. Springer; Berlin/Heidelberg, Germany: 2002. The precursors of malignant melanoma; pp. 75–84. - PubMed
    1. Patel S.G., Prasad M.L., Escrig M., Singh B., Shaha A.R., Kraus D.H., Boyle J.O., Huvos A.G., Busam K., Shah J.P. Primary mucosal malignant melanoma of the head and neck. Head Neck. 2002;24:247–257. doi: 10.1002/hed.10019. - DOI - PubMed
    1. Merkel E.A., Gerami P. Malignant melanoma of sun-protected sites: A review of clinical, histological, and molecular features. Lab. Investig. 2017;97:630–635. doi: 10.1038/labinvest.2016.147. - DOI - PubMed

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