Head and Neck: Primary oral mucosal melanoma

Abstract

Primary Oral Mucosal Melanoma (POMM) is an aggressive and rare disease that involves mostly the hard palate and upper gingiva, followed by mandibular gingiva, lip mucosa, and other oral sites. POMM develops primarily between the 5th and 8th decades of life and most studies report a similar distribution between males and females. In contrast to cutaneous melanomas, the risk factors and pathogenesis are poorly understood. However, genetic profiling of mucosal melanomas have identified a number of altered genes, such as KIT, BRAF and N-RAS, suggesting that molecular pathways like the mitogen-activated protein kinase (MAPK) pathway (RAS/MEK/ERK) and the phosphotidylinositol-3-kinase-PTEN pathway (PI3K/AKT/PTEN/mTOR) might be used for potential targeted therapy.

Oral Mucosal Melanoma: A Case Report and Literature Review

“…Specifically, the malignant melanocytes can show different phenotypes (polyhedral, round, epithelioid, spindle-shaped or pleomorphic) and sizes (Barnes, 2000). They exhibit clear cytoplasm, round to oval nuclei, with one or more hyperchromic ("cherry red") or prominent nucleoli, and single cells can be found along the epithelium (in situ, invasive and combined pattern) or grouped in nests mainly below the interface (invasive and combined pattern), with or without the presence of seromucous glands (in situ pattern) and with intracellular melanin (Barnes, 2000;Coutinho-Camillo et al, 2016). Occasionally, due to the histological diversity of the lesion, auxiliary immunohistochemical (IHC) markers are required to identify S100, Mart1/Melan-A, MITF and HMB45 proteins, which are determinants to confirm the diagnosis of OMM (Table II) (Coutinho-Camillo et al, 2016;Smith et al, 2016;Feller et al, 2017;Topic´ et al, 2017).…”

Mucosal Melanoma of the Head and Neck: From Diagnosis to Treatment

“…Tumors with mixed cell phenotypes are more related with vascular invasion and the development of metastasis. The neoplastic proliferation is commonly found along the junction between the epithelial and lamina propria, but this may be difficult to detect in advanced and ulcerated lesions [70].…”