Congenital Melanotic Macules of the Tongue. A Case Report and Brief Review of the Literature

Abstract

Congenital melanotic macules of the tongue (CMMT) are a rare and benign condition that is probably underestimated. We report the case of an African infant with multiple congenital hyperpigmented macules of the tongue. To avoid a difficult-to-perform procedure such as a tongue biopsy, focused clinical monitoring was performed every 3 months for 30 months to detect significant changes. A clinical diagnosis of CMMT was made in the absence of concomitant systemic diseases using the clinical findings, the location on the tongue, the negative family history for melanoma, and the absence of drugs and toxic exposure. Clinical follow-up may be sufficient to monitor CMMT rather than performing a tongue biopsy.

Lingual melanotic macule - the first case report in an adult patient

“…In most cases, such diagnoses can be ruled out through clinical history and physical examination. 1 , 2 , 4 …”

“…found 14 cases of congenital lingual melanotic macules. 4 The present case would be the first and only described in an adult patient, based on a survey conducted in December 2016 on PubMed using the keywords "tongue", "melanotic macule," and "adult".…”

“…Most melanotic macules are congenital, affect Caucasian individuals, may be single or multiple, have a diameter varying between 0.3cm and 3cm, tend to grow in proportion to the body growth, and are unrelated to any systemic condition. 2 , 4 Their clinical features are not yet well-defined. 1 , 2 The etiology of the disease still remains uncertain, but it is suggested that congenital cases may represent melanocyte hamartomas.…”

“…Some authors recommend anatomopathological examination for diagnostic confirmation, although others sustain that the diagnosis is only clinical and follow-up is necessary to investigate changes in size, shape, and color of the lesion. 2 , 4 Although the number of documented cases allows no definitive conclusions, a clinical diagnosis of congenital melanotic macule of the tongue should be considered in the presence of the following characteristics: single or multiple lingual melanotic lesions, presence of a macular lesion at birth with proportional growth, and absence of family history of systemic conditions associated with mucosal pigmentation. 2 For acquired cases, lingual melanotic macules, although rare, should be considered in the differential diagnosis of pigmented lesions of the oral mucosa.…”

Congenital Melanocytic Macule of the Tongue in a Newborn

“…Because there are technical difficulties associated with invasive procedures, such as surgery or biopsy, that are performed on a child, close follow-up of this type of lesions should be performed. The lesions would likely increase in size with a child’s growth [ 2 ]. We report the first case of a Hispanic infant with a congenital hyperpigmented macule of the tongue at Woodhull Medical Center in Brooklyn, New York, USA.…”