Oral malignant melanoma

doi:10.1016/0007-117X(75)90022-0

British Journal of Oral Surgery

Volume 13, Issue 1, July 1975, Pages 40-55

British Journal of O...

https://doi.org/10.1016/0007-117X(75)90022-0 Get rights and content

Abstract

Sixty-five cases of oral malignant melanoma are reviewed, comprising 53 cases taken from the literature and 12 unreported cases. The classification of tumours on clinical and histopathological grounds is suggested to be comparable to that for cutaneous melanoma.

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Cited by (73)

Pediatric melanoma: a single-institution experience of 150 patients
2009, Journal of Pediatric Surgery
Citation Excerpt :
None of our patients developed oral mucosal melanomas. The prognosis of oral mucosal melanomas is poor, with 5-year survival rates between 13% and 20%, whereas 5-year survival of ocular melanomas is better at 60% [15-17]. Ocular melanoma is unusual in children [17].
Differentiating pigmented skin lesions from malignant melanoma in the pediatric population has been a challenge. Despite guidelines describing clinical features and histopathologic criteria to distinguish these lesions, misdiagnoses still occur. We report our experience over 30 years in a pediatric population with malignant melanoma.
We performed a retrospective review of 150 pediatric patients treated for malignant melanoma between 1973 and 2007 at our institution. Outcomes measured included age, Breslow thickness, Clark level of invasion, tumor location, local and distant failure rates, and overall survival.
One hundred fifty pediatric patients were evaluated. The mean age was 15.1 years. The mean Breslow thickness was 2.05 mm and corresponding Clark level of invasion was 3.47. There were 43 known recurrences (29%); 29 distant, 14 nodal, and 7 local. Overall survival was 84% with a mean follow-up of 8.5 years. Sixteen patients (10.7%) were incorrectly diagnosed on initial pathologic examination. Overall survival in the misdiagnosed group was 66%.
Pigmented skin lesions in the pediatric population represent a diagnostic challenge to pathologists and clinicians. Improvements in diagnostic techniques with rigorous characterization, as well as increased physician awareness, should lead to a reduction in errors of diagnosis.
Tumor Size and Depth in Primary Malignant Melanoma in the Oral Cavity Influences Survival
2009, Journal of Oral and Maxillofacial Surgery
Citation Excerpt :
Chemotherapy and systemic adjuvant therapies have not been supported for intraoral OMMs in recent trials14,35,36 but should be kept in mind for adjuvant and palliative purposes or the therapy of metastatic melanoma,13,20,35 provided that treatment does not further reduce the patient's quality of life. Although we present a small sample of patients, our results are in accordance with reports with encouraging treatment results.6,13 Controversy still remains on the issue of prophylactic neck dissection.20,37
Primary oral malignant melanoma (OMM) is rare, and there are few studies examining the impact of this disease. This study aims to assess the outcome of surgically treated patients with OMM treated at a single institution.
Ten patients with OMM treated at the Department of Oral and Maxillofacial Surgery, Ruhr-University Bochum, Bochum, Germany, between 1992 and 2002 were analyzed retrospectively. Treatment included wide local excision with or without modified neck dissection, supplemented by radiotherapy and chemotherapy. Clinical and histologic data were analyzed by univariate analysis.
Five patients were diagnosed with stage I disease, 4 with stage II disease, and 1 with stage III disease at presentation. The alveolar arch (40%) and palate (30%) were the most frequently affected sites. The adjusted hazard ratio was 4.513 (95% confidence interval, 1.47-13.89) for size and 1.919 (95% confidence interval, 1.03-3.59) for depth, yielding a poor prognosis (P = .009 and P = .048, respectively). The mean survival rate of the patients succumbing to disease was 19 ± 17 months.
Primary OMM carries a poor prognosis. Early identification of OMM and its treatment by radical surgery comprise the single most important treatment strategy. Any pigmented lesion in the oral cavity not clearly clinically amenable to diagnosis should be excised for histologic confirmation. Analysis of the lymph node status, supplemented by sonography or other imaging, and postoperative histologic evaluation of the size and depth should be performed routinely. In cases in which the mucosal melanoma may not be the primary site, all potential primary sites should be examined.
Malignant melanoma in childhood and adolescence: Report of 13 cases
2005, Journal of the American Academy of Dermatology
Citation Excerpt :
They tend to grow and form metastases in cervical lymph nodes.53 The prognosis of oral mucosal melanoma is poor, with 5-year survival rates reported between 13% and 20%.54,55 To date, only 5 cases have been reported in patients younger than 20 years.54,56-58
We reviewed all cases of malignant melanoma in children younger than 17 years of age who were evaluated at Sainte Justine Hospital, a tertiary care pediatric center, between 1980 and 2002. The medical records and histologic features of all cases were reviewed. Thirteen cases were identified, 4 boys and 9 girls. Fifty-three percent of patients were prepubescent. None of the patients had a predisposing condition (eg, giant congenital nevi, dysplastic nevus syndrome, or xeroderma pigmentosum). One patient had had chemoradiotherapy previously for an undifferentiated pleuropulmonary malignant tumor (blastoma) and another patient had Down syndrome. The most frequent reason for initial consultation was a recent increase in size of the lesion. Three patients had pyogenic granuloma–like lesions. Eighty-five percent of the observed melanomas were nodular in type. Tumor thickness ranged from 0 to 6 mm with a median and mean thickness of 2.8 and 3.2 mm, respectively. The overall 5-year survival rate was 58.8%. Lack of awareness and delay in diagnosis may lead to a higher incidence of thick and intermediate melanoma in children. Because it appears that the majority of melanomas in childhood and adolescence occur de novo, clinicians should consider this condition in the differential diagnosis of any suspect lesion in children and adolescents even without an identified predisposing factor.
Oral mucosal melanoma: A series of case reports
2004, Journal of Cranio-Maxillofacial Surgery
Introduction: Due to the rarity of oral malignant melanomas case reports are a necessary source of information. Ten new cases are reported with a minimum follow-up of 3 years. Patients and methods: Patients were treated during a period of 10 years. Clinical, demographic and pathologic findings were examined. Results: In 6 males (60%) and 4 females with a mean age of 64.3 years the tumour locations were: hard palate-maxillary gingiva (3 cases), maxillary gingiva (2), lower gingiva (2), tongue (2), hard/soft palate-buccal mucosa (1). Pre-existing melanotic pigmentation had been present in 4 patients. Four patients were in stage I, 5 in stage II, and 1 in stage III. Surgical excision was the primary treatment in 9 cases. Five patients underwent simultaneous neck dissections. All patients received radiation and multimode adjuvant therapies. After a 3-year follow-up 3 patients are still alive (50% (2/4) of those presenting in stage I and 20% (1/5) in stage II). Conclusions: Due to the rarity of oral melanoma, individual experience is limited. The poor prognosis and the different treatments reflect this situation.
Primary malignant melanoma of the oral mucosa
2003, Journal of Oral and Maxillofacial Surgery
The occurrence of primary oral melanoma is very rare. Large clinical series suggesting appropriate treatment modalities are lacking; the clinician has to rely on case reports to gain insight into the management of this tumor, which is much more aggressive than its skin counterpart.
The cases of 5 patients with primary oral melanoma during a 6-year period were retrospectively reviewed. Four patients presented with tumors located in the maxilla. Preoperative workup included microscopic examination of incisional biopsy specimens for the confirmation of the diagnosis and thorough imaging of the body to rule out distant metastases. Histologically significant vertical invasion was found in all patients. No patient had distant metastases initially, and only 1 patient presented with neck disease. Primary treatment included wide local excision in 4 patients and therapeutic modified radical neck dissection in the 1 patient with neck node involvement on presentation. One patient was treated primarily with radiation therapy due to medically compromised status. Adjuvant immunochemotherapy (DAV protocol) was administered to 4 patients. Radiation therapy was used in an adjuvant fashion in 3 patients.
All of the patients developed distant metastases to the lung and liver and eventually died of their disease. Survival ranged from 14 to 38 months (mean, 25.6 months). Local recurrence occurred in 1 patient and was attributed to positive surgical margins. Contralateral neck disease developed in the patient who underwent therapeutic neck dissection.
The prognosis of primary oral melanoma remains poor despite adequate locoregional control of the disease. It seems that diagnosis is made late in the course of the disease when the primary tumor has already shed microscopic distant metastases.
Primary malignant melanoma arising in the dorsum of the tongue
2003, British Journal of Oral and Maxillofacial Surgery

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^☆: Awarded the prize for the best clinical paper read by a member of the British Association of Oral Surgeons, 1974.

View full text

Oral malignant melanoma☆

Abstract

Oral Surgery, Oral Medicine, Oral Pathology

American Journal of Surgery

Oral Surgery, Oral Medicine, Oral Pathology

Oral Surgery, Oral Medicine, Oral Pathology

Oral Surgery, Oral Medicine, Oral Pathology

Cancer

Oral Surgery, Oral Medicine, Oral Pathology

Oral Surgery, Oral Medicine, and Oral Pathology

Oral Surgery, Oral Medicine, Oral Pathology

Pathology

Oral Surgery, Oral Medicine, Oral Pathology

Pathology

Oral Surgery, Oral Medicine, Oral Pathology

Oral Medicine, Oral Surgery, Oral Pathology

American Journal of Surgery

Oral Surgery, Oral Medicine, Oral Pathology

Annals of Faculty of Medicine of Montevideo

Cancer

Canadian Medical Association Journal

Australian Journal of Dermatology

Archives of Otolaryngology

Annals of the Royal College of Surgeons of England

British Journal of Surgery

Annals of the Royal College of Surgeons of England

American Journal of Roentgenology

Cancer Research

New Zealand Dental Journal

Surgery, Gynaecology and Obstetrics

British Journal of Surgery