Oral mucosal melanoma: a series of case reports

Garzino-Demo, Paolo; Fasolis, Massimo; Terra, Marco H.; Pagano, Mario; Berrone, Sid

doi:10.1016/j.jcms.2003.12.007

Cited by 69 publications

(85 citation statements)

References 57 publications

(72 reference statements)

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“…Certains se déterminent en fonction du ganglion sentinelle : ce premier relais ganglionnaire peut être détecté par injection de bleu de méthylène ou d'un radiotraceur autour du mélanome. Après son repérage, le ganglion est prélevé et examiné histologiquement : le curage est envisagé seulement si une métastase ou une micrométastase est décelée [19]. La radiothérapie peut être primaire pour les grosses tumeurs inopérables ou chez les patients âgés, ou complémentaire car elle permettrait un meilleur contrôle local sans modification significative de la survie [20,21].…”

Section: Discussionunclassified

Mélanomes de la cavité buccale : présentation de 3 cas

Haïtami¹,

Yahya²,

Kinani³

et al. 2011

Med Buccale Chir Buccale

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Résumé -Le mélanome est une tumeur qui se développe à partir des cellules pigmentaires dérivant des crêtes neurales. Les mélanomes buccaux constituent 0,4 à 8 % de l'ensemble des tumeurs mélaniques. Ils atteignent plus l'homme entre 50 et 60 ans, et se développent essentiellement sur la muqueuse palatine, la gencive, les lèvres. L'étiopathogénie demeure inconnue; il existerait cependant une prédisposition génétique mais aucun précurseur bien défini n'a été isolé. Les microtraumatismes répétés sur un naevus bénin pré-existant ont également été incriminés. L'évolution du mélanome se fait en 2 phases : d'abord horizontalement, puis verticalement. La très haute malignité, l'agressivité et le sombre pronostic de cette tumeur en font une entité dont le diagnostic précoce permet d'améliorer de façon importante le taux de survie des patients. Nous présentons 3 cas de mélanomes dont le diagnostic tardif a rendu la prise en charge difficile et le pronostic sombre.Abstract -Oral melanoma: 3 cases report. The melanoma is a tumor which develops from the pigmentary cells diverting neural crests. The oral melanomas constitute 0.4 to 8% of all the melanic tumors. They affect more the men between 50 and 60 years, essentially at the palatine mucous membrane, the gum, the lips. The etiopathogeny is unknown; there would be however a genetic predisposition but no well defined precursor was isolated. The repeated microtraumas on a pre-existing mild naevus were also incriminated. The evolution is made in 2 phases: at first horizontally then vertically. The very high wickedness, the aggressiveness and the somber forecast of these tumors make it entities in which the early diagnosis allows to improve the rate of survival of the patients. We present through this work 3 cases of oral melanomas; the late diagnosis maked the care difficult and the prognosis dark.

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Section: Discussionunclassified

Mélanomes de la cavité buccale : présentation de 3 cas

Haïtami¹,

Yahya²,

Kinani³

et al. 2011

Med Buccale Chir Buccale

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“…Besides the head and neck region, mucosal melanomas arise from the mucosal membranes of the female genital organs or the anorectal region and urinary tract. 5 A few authors have reported a slight male predominance. 5,6 They are more common in the elderly; however, the indexed case was relatively young.…”

Section: Discussionmentioning

confidence: 99%

Primary Malignant Melanoma of the Gingiva: A Case Report and Review of Literature

Singhal¹,

Mohan²,

Lehl³

et al. 2011

JIAOMR

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Mucosal melanoma of the head and neck is a relatively rare condition that has been poorly understood, characterized and studied.A 28-year-old male patient reported a swelling in relation to the right upper incisor teeth. The lesion was mobile, with slight bleeding on probing. Differential diagnosis of gingival hyperplasia/fibrosis, giant cell epulis, Kaposi's sarcoma, and malignant melanoma were kept. Histopathological sections showed sheets of pleomorphic spindle cells with intracytoplasmic brown-black pigment, involving the lower part of the squamous epithelium. Tumor cells were positive for S-100 and HMB-45 (Human Melanoma Black) immunostain and a diagnosis of malignant melanoma was rendered. The patient underwent partial maxillectomy and the case was categorized as stage II. He also received regional radiotherapy; however after five months, the patient presented with a metastasis to the lymph nodes that was confirmed on fine needle aspiration cytology (FNAC). The patient underwent radical neck dissection that showed a large tumor mass.In contrast to cutaneous melanoma, the mucosal melanomas have an aggressive vertical growth phase. Different cell types, like spindled, plasmacytoid, and epithelioid may be observed. The treatment of choice is complete excision with adequate negative margins. The role of radiotherapy is not clearly defined since malignant melanoma is relatively insensitive to radiation. The prognosis for mucosal melanoma is generally quite poor because of its tendency to invade and cause early hematogenous metastasis. Nodal involvement reduces survival time and multiple local recurrences are the most common cause of treatment failure.

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“…Cytological tests on brushed samples seem not to be reliable [4] and are, like fineneedle aspiration, contraindicated [3]. Concerning biopsies in malignant melanomas, dissemination of malignant cells in the tissue, blood, or lymphatic stream is discussed.…”

Section: Excisional Versus Incisional Biopsymentioning

confidence: 99%

“…Most authors advocate wide local excision of the tumor [4,22]. Oral malignant melanomas are not very radiosensitive, but postoperative radiotherapy is generally recommended in multiple positive nodes, in extranodal spread, and in poor prognostic pathologic features [7,23].…”

Section: Treatmentmentioning

confidence: 99%