Oral melanoma and other pigmented lesions of the oral cavity

“…Some direct histopathologic correlations can be made between human and canine melanoma in that both forms may be composed primarily of spindle cells, epithelioid or round cells, or a mixture of these cell types. 70 There are similarities between oral melanoma in dogs and humans. As in dogs, the prognosis for oral melanoma in humans is very poor regardless of morphology, 70 and no link has been found between survival rate and histologic type.…”

Section: Histopathologic Variants Histopathologic Variants In Animalsmentioning

confidence: 99%

“…70 There are similarities between oral melanoma in dogs and humans. As in dogs, the prognosis for oral melanoma in humans is very poor regardless of morphology, 70 and no link has been found between survival rate and histologic type. 72 Cutaneous melanomas in humans are most commonly classified according to their growth pattern variants.…”

Section: Histopathologic Variants Histopathologic Variants In Animalsmentioning

confidence: 99%

“…There is no evident relationship between histologic characteristics, including mitotic index and pigmentation, and survival rate. 70,190 The prognosis for human melanoma at mucocutaneous junctions and mucosal surfaces is also grave. 203 In animal skin and eye melanocytic neoplasms, the most reliable histologic feature for distinguishing malignant from benign is the mitotic index.…”

Section: Criteria Of Malignancymentioning

confidence: 99%

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A Comparative Review of Melanocytic Neoplasms

2002

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Abstract. Melanoma is a devastating disease frequently encountered within both veterinary and human medicine. Molecular changes linked with neoplastic transformation of melanocytes include mutations in genes that encode proteins intrinsic to the regulatory pathways of two tumor suppressor proteins (retinoblastoma protein and p53), proto-oncogene mutation to oncogenes, altered expression of epithelial cadherin and CD44 adhesion molecules, and upregulation of angiogenic factors and other growth factors. Histologic evaluation of the primary mass is the most common means of diagnosis, with cytology used more frequently to document metastasis. Melanoma's highly variable histologic and cytologic patterns can make diagnosis by either method problematic. Adherent epithelioid morphology, including signet ring forms, and nonadherent round and spindle forms are recognized, with pigmentation an inconsistent finding. The site of the tumor, the thickness of the primary tumor or depth of invasion, and the number of mitotic figures per high-power field or per millimeter are used histologically to predict biologic behavior, whereas site and degree of pleomorphism are typically used for cytologic preparations. Diagnosis of amelanotic melanoma can be aided by ancillary diagnostic techniques. Tumor cells are usually positive for vimentin, S100, neuron-specific enolase, and Melan-A, and negative for cytokeratin. Melan-A as a positive marker is not as sensitive as the others are but is likely more specific. Monoclonal antibodies to human melanosome-specific antigens 1 and 5 cross-react with canine antigens for a combined sensitivity rate of 83%. Mouse monoclonal antibody IBF9 specifically recognizes canine melanoma antigen and also has good sensitivity. Serologic markers, including cytokines, cell adhesion molecules, and melanoma-inhibitory activity, are being investigated as potential sentinels of melanoma. Currently, there is no single diagnostic technique capable of differentiating benign from malignant melanocytic neoplasms or predicting survival time.

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“…Differential diagnosis of oral mucosal melanoma 47,48 has been summarized in Table 2. The most common mimickers of mucosal melanoma of the oral cavity are amalgam tattoos (Fig.…”

Section: Dermoscopy Of An Amalgam Tattoo Dermoscopy Image Showing a mentioning

confidence: 99%

Melanoma of the oral cavity: pathogenesis, dermoscopy, clinical features, staging and management

Warszawik-Hendzel

Słowińska²,

Olszewska

et al. 2014

J Dermatol Case Rep

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Primary mucosal melanoma of the oral cavity is an exceedingly rare neoplasm which is estimated to comprise 1-2% of all oral malignancies. In contrast to cutaneous melanomas, the risk factors and pathogenesis are poorly understood. The predominate localization of primary oral melanoma is hard palate and maxillary alveolus. Dermoscopy may be utilized as an adjunctive tool in the clinical differential diagnosis of oral mucosal melanoma whenever the lesion is accessible with a dermoscope. Surgery is the mainstay of treatment, but it may be challenging depending on the location of the tumor within the oral cavity and its size. Adjuvant therapy with dacarbazine, platinum analogs, nitrosoureas and interleukin-2 have been utilized with low response rates. Imatinib may be effective for patients with with c-Kit gene mutations. Sunitinib and dasatinib have been reported effective in selected cases. Vemurafenib and dabrafenib are targeted agents for patients with BRAF mutation-positive melanoma. Ipilimumab, an anti-cytotoxic T-lymphocyte antigen 4 antibody and pembrolizumab, a monoclonal antibody targeting programmed death 1 receptor may be a feasible treatment option in patients with metastatic mucosal melanoma. (J Dermatol Case Rep. 2014; 8(3) Melanoma is a malignant tumor that arises from melanocytes and is most commonly cutaneous in origin. Extracutaneous melanomas are known to be exceedingly rare and aggressive neoplasms that embrace ocular, mucosal and leptomeningeal melanomas. EpidemiologyMucosal melanomas are estimated to comprise 4-6.8 % of all primary melanomas. 1The incidence rate for mucosal melanoma (MM) is 2.3 per million. 1,2The incidence of MM increases with age. Older patients have tenfold higher incidence of MM compared to patients under the age of 60 years. 2Primary oral mucosal melanoma (POMM) is excessively uncommon in prepubertal children. 3Although there is a slight male preponderance (1.2:1), 1,4 some studies have been reported higher gender distribution of mucosal melanoma for women, 5,6 other indicate that there is no significant difference between sexes in the incidence of this tumor. 2,7The incidence rate of POMM is highest among Asian men. 3,6 Among the Japanese oral melanoma accounts for 7.5 % of all melanomas versus less than 1 % in Caucasians. 8,9Pathogenesis In contrast to cutaneous melanomas, the etiology and pathogenesis of POMM is poorly understood and no etiological and intraoral risk factors, other than preexisting pigmented nevi, have been identified. 10,11 POMM are believed to arise from pigmented nevi, pre-existing pigmented areas or de novo (30% cases) from apparently normal mucosa. 9,12 Although Kahn et al 13 described transformation of a benign oral pigmentation to primary oral melanoma, a definite precursor lesion has not been identified. 14,15 In the oral cavity, mechanical trauma including injury from ill-fitting prostheses, infection, tobacco use has been cited as possible causative factors, but its etiological role seems unlikely. 30Amelanotic oral melanoma is partic...

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Oral melanoma and other pigmented lesions of the oral cavity

Cited by 68 publications

References 95 publications

Differential diagnosis of an oral mucosal pigmented lesion: a case of essential melanosis

Differential diagnosis of an oral mucosal pigmented lesion: a case of essential melanosis

A Comparative Review of Melanocytic Neoplasms

Melanoma of the oral cavity: pathogenesis, dermoscopy, clinical features, staging and management

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