Malignant Melanoma of Oral Cavity, a Case-Based Review of the Literature

Abstract

Introduction: Primary Mucosal Malignant Melanoma is an aggressive cancer, especially when there is a late diagnosis. The mortality is low in early stages but in advanced stages is less than a 30% on a 5-years following. Only a 0.5% to 3% of Melanomas are Mucosal Melanomas. Among them, the Mucosal Malignant Melanoma of oral cavity is a rare tumor, with an extremely aggressive behavior at diagnosis.

Case Report: 51 years old male, consult on April 2015, at Centro de Salud Familiar Flor Pedreros Parra, Trehuaco city, Chile, for dark blue round tumor, 1.5 cm wide, placed near the tooth 1.3, compromising the gum. The patient refers previous consultations with a smaller and flat lesion. He reveals important everyday sun exposure, without proper UV protection. One month later, the tumor grows and becomes indurate, consequently the patient was transferred to Herminda Martin Hospital of Chillán City, where incisional biopsy concludes “Mucosal Malignant Melanoma with infiltration of surroundings tissues”. Chemotherapy is realized with poor results. Last control with Odontology in August 2015, the tumor evolves to a black nodule, 4 cm wide, compromising the upper maxilla, right eye and mouth opening, concomitant to multiple black satellite papula. Computed Tomography showed skull base infiltration, cervical lymphatics and other zones of head and neck. The patient was transferred to palliative care and died before a year from diagnosis.

Discussion: The primary Mucosal Malignant Melanoma of oral cavity it’s a very strange condition. It has variable presentations, sometimes like a little maculae with different colors or like a highly pigmented tumor with ulcers or hemorrhage, with a high growing rate. It has an important metastatic potential and a poor prognostic. This is the reason why early clinical suspect and diagnosis is extremely valuable.