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Case Reports
. 2021 Sep 14;57(9):965.
doi: 10.3390/medicina57090965.

Treatment Modalities of Recurrent Oral Mucosal Melanoma In Situ

Philipp Becker  1   2 , Andreas Pabst  1   2 , Monika Bjelopavlovic  3 , Daniel Müller  2 , Peer W Kämmerer  2
Affiliations
Case Reports

Treatment Modalities of Recurrent Oral Mucosal Melanoma In Situ

Philipp Becker et al. Medicina (Kaunas). .

Abstract

Oral mucosal melanoma (OMM) represents an extremely rare entity that is associated with a poor prognosis due to late diagnosis and early metastasis. Here, extensive surgical therapy is the therapy of choice. In contrary, for OMM in situ, the respective therapeutical recommendations are lacking. In this case report, treatment modalities of an OMM in situ of the palate, including the maxillary alveolar process, are reported. The tumor relapsed twice despite adequate surgical therapy and reconstruction. Therefore, irradiation was performed as an adjuvant therapy. At a follow-up of two years, the patient was free from recurrences.

Keywords: dental implant; hard palate; head and neck cancer; in situ; irradiation; melanoma; oral mucosa; oral neoplasm.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Clinical findings at first visit: on the labial marginal gingiva of tooth 11 and in the area of the anterior hard palate, an indistinctly delimited blackish oral mucosal change is evident, which is clinically highly suspect of an oral mucosal melanoma.
Figure 2
Figure 2
MRI (axial slices, T2)–tumor formation in the front region of the upper jaw.
Figure 3
Figure 3
After resection, the specimen was oriented and fixed for histopathological examination.
Figure 4
Figure 4
First recurrence of oral mucosal melanoma: in region 012, there was a 2 × 2 mm dark mucosal macule (white arrow), which was highly suspicious of a relapse of the OMM.
Figure 5
Figure 5
Radiographic follow-up after implant placement: two dental implants (each 3.7 × 10 mm, BLX, Straumann, Basel) were placed.
Figure 6
Figure 6
Second recurrence of OMM: irregular, light-brown changes and a fibrin-covered ulceration in the palatal mucosa are evident (white circles).
Figure 7
Figure 7
Condition after resection of the second recurrence and exposure of the implants: the changes in the oral mucosa were resected with safety margins. The implants in regions 12 and 21 were exposed and restored with gingival formers.
Figure 8
Figure 8
Single-tooth radiograph showing dental implants together with the final restauration.
Figure 9
Figure 9
Patient-specific 3D-printed device combining a tongue-depressing radiation stent and buccal retractor: (a) CAD construction and (b) device installed in the patient.
Figure 9
Figure 9
Patient-specific 3D-printed device combining a tongue-depressing radiation stent and buccal retractor: (a) CAD construction and (b) device installed in the patient.
Figure 10
Figure 10
Oral situation after 2 years with prosthetic restauration.
See this image and copyright information in PMC

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