Primary Mucosal Melanoma of Maxilla: A Case Report and Review of Literature.

ABSTRACT

Oral malignant melanomas are extremely rare lesions and occur commonly in the maxillary gingiva more frequently on the palate with fewer incidences in the mandibular gingiva. Malignant melanomas of oral cavity are extremely rare accounting for 0.2-8% of all malignant melanomas. A 51-year-old female reported a growth about left maxillary region with black pigmentation in anterior maxillary region and palatal region. Differential diagnosis of gingival hyperplasia, 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 a human melanoma black-45 immunostain, and a diagnosis of malignant melanoma was rendered. The patient underwent partial maxillectomy on left side and the case was categorized as Stages I level III. Complete excision with adequate negative margins is the treatment of choice. Malignant melanoma is relatively insensitive to radiation; hence, the role of radiotherapy is not well-defined. The tendency to invade and cause early hematogenous metastasis results in poor prognosis. The most common cause of treatment failure is Nodal involvement and multiple local recurrences.