Oral mucosal melanoma is a very rare type of malignant melanoma, the characteristics of which differ from those of cutaneous melanoma. Primary amelanotic melanoma of the mandibular gingiva, which can invade the mandibular bone, is very rare worldwide. Here, we report a case in which we performed a reconstruction of the mandible and gingiva using the fibula osteocutaneous free flap procedure to treat a patient diagnosed with a primary amelanotic melanoma of the mandibular gingiva. The procedure was successful, and no recurrence was observed 10 months after surgery. Oral mucosal melanoma has a much poorer prognosis and a lower 5-year survival rate than cutaneous melanoma. However, recently, immunomodulatory therapies for mutations in melanocytic lesions have been used effectively to treat the increasing number of patients developing this type of melanoma, thus improving the prognosis of patients with oral mucosal melanoma.
Background: Intravascular lymphomatosis (IL) usually produces vascular occlusion due to the angiotropic nature, which can result in infarct like lesions. Herein, we report a case of pathologically confirmed IL presenting with intracerebral hemorrhage (ICH). Case Report: A 53-year-old female was admitted for both legs weakness. Brain Magnetic resonance image (MRI) showed ICH on bilateral cerebral hemispheres. Spinal MRI showed lesion with patchy contrast enhancement. Cerebrospinal fluid (CSF) revealed an elevated red blood cell and white blood cell, with normal protein and glucose level. High dose glucocorticoid was given under the impression of vasculitis and the state of the patient showed transient improvement, but got worsened eventually. Chest computer tomography (CT) showed consolidation. Through lung biopsy, she was diagnosed with IL. Conclusion: This is a case of brain IL complicated by ICH not associated with coagulopathy. Increasing awareness of IL as a differential diagnosis may lead to more opportunities for treatment.
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