6533b854fe1ef96bd12af4a6

RESEARCH PRODUCT

Primary malignant melanoma of the oral cavity: case report.

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An 80-year-old-female patient had a pigmented lesion on: the hard palate, the soft palate, the alveolar mucosa and the vestibolar mucosa of the maxillary gingiva. Pigmented macules and patchs had been persistent and asymptomatic for many years (Fig. 1). The lesion exhibited irregularities of pigmentation, border and surface contour. About 1 year later the patient had noticed an extension of the pigmented macules and plaques; there was also the appearance of nodules of the maxillary gingiva accompanied by swelling. Loosening of teeth as a result of extensive destruction of bone was further noted (Fig. 2). Figure 1. Pigmented macules and patchs with irregularities of pigmentation, border and surface contour Download figure to PowerPoint Figure 2. About one year: nodules of the maxillary gingiva accompanied by swelling and loosening of teeth Download figure to PowerPoint The histological examination showed a downward streaming in the dermis of the tumor cells and a disintegration and ulceration of the epidermis (Fig. 3). An increased number of large round or polygonal cells resembling atypical epithelioid cells were found on the submucosa. The atypical cells had enlarged, pleomorphic nuclei with prominent and sometimes multiple nucleoli. Mitoses were observed at various tissue levels (Fig. 4). Abundant pigmented melanin was present in the tumor cells (Fig. 5). Many cells had fine, dusty melanin particles. The tumor cells showed great variations in size. Immunohistochemical staining, with S100 protein and HMB45 antibodies, stained many of the spindleshaped cells, indicating that they were melanocytic cells. An inflammatory infiltrate of lymphocytes was seen in a band beneath the invading tumor cells. Figure 3. An increased number of large round or polygonal cells resembling atypical epithelioid cells were found on the submucosa, the epidermis is atrophic (200×) Download figure to PowerPoint Figure 4. Mitoses were observed at various tissue levels (400×) Download figure to PowerPoint Figure 5. Abundant pigmented melanin was present in the tumor cells (250×) Download figure to PowerPoint