Primary melanoma of the oral cavity: A multi-institutional retrospective analysis in Brazil / Melanoma primario de la cavidad bucal: Un análisis retrospectivo multiinstitucional en Brasil

Background: Melanoma is an aggressive malignant tumor, rarely observed in the oral cavity. The aim of this studywas to describe the clinicopathologic features of a series of oral melanomas.Material and Methods: A retrospective descriptive study was performed. A total of 15,482 biopsy records from twooral and maxillofacial pathology services in Brazil were analyzed. All cases of oral melanomas were reviewed,and clinical, demographic, histopathological data, treatment, and follow-up status were collected. In addition, im-munohistochemistry stains (pan-cytokeratin AE1/AE3, vimentin, α-SMA, CD45, S-100 protein, HMB-45, MelanA, and Ki-67) were performed Results: The series comprised of 5 males (71.4%) and 2 females (28.6%), with a mean age of 58.0 ± 9.2 years (range:45-69 years) and a 2.5:1 male-to-female ratio. The gingiva (n = 3, 42.8%) and hard palate (n = 2, 28.6%) were the mostcommon affected sites, presenting clinically as ulcerated swellings with a brown to black color. Cervical lymph nodemetastasis was detected in three patients during the first examination. Microscopically, 6 cases (85.7%) were mela-notic, and one (14.3%) was amelanotic. Most cases (n = 4, 57.1%) presented a predominance of epithelioid cells. S-100and HMB-45 were positive in all cases (n = 7, 100.0%). In contrast, only 4 cases (57.1%) were positive for Melan-A.The proliferative index with Ki-67 was high, with labeling index ranging from 70.0% to more than 90% of positivecells. Five patients died from complications of the tumors after a mean follow-up period of 7.8 months.Conclusions: Melanoma is an aggressive malignant tumor that rarely occurs in the oral cavity. It occurs mainly inadult and elderly patients and often is diagnosed in advanced stages. The current findings were similar to previousstudies and reflected the characteristics of the services from where lesions were retrieved.(AU)

Lesões pigmentadas da mucosa oral: estudo retrospectivo / Pigmented lesions of the oral mucosa: retrospective study

As lesões pigmentadas são incomuns na mucosa oral e apresentam uma grande variedade etiológica, assim os estudos que investigam a distribuição dessas lesões são importantes para melhorar o conhecimento clínico, auxiliando no diagnóstico O objetivo deste estudo foi analisar a distribuiçã e tratamento desse grupo de lesões o de lesões pigmentadas da mucosa oral . em uma população do sudeste brasileiro. Foi realizado um estudo transversal retrospectivo descritivo. As lesões pigmentadas diagnósticos histopatológicos da mucosa oral de dois serviç foram recuperadas dos arquivos de os de patologia oral e maxilofacial nos estados de São Paulo e Rio de Janeiro, Brasil, durante um período de 45 anos (19742019). Os dados clínicos e diagnósticos de cada caso foram recuperados e incluídos em um banco de dados Microsoft Excel® . Das 77.074 lesões diagnosticadas neste período, 761 (0,99%) representavam lesões pigmentadas da mucosa oral, incluindo 351 (46,1%) melanocíticas e 410 (53,9%) lesões não melanocíticas, com maior incidência no sexo feminino (73,2%) entre a quarta e sétima décadas de v ida. A tatuagem por amálgama (53,6%) representou a lesão mais comum, seguida pela mácula melanótica (18,3%) e pigmentação racial (10,8%). A mucosa jugal foi o local mais acometido (25,2%), seguido pela crista alveolar (14,5%) e gengiva (11,8%). Outras lesõ pigmentadas incluíram nevo, pigmentação póses inflamatória, melanoma, melanoacantoma, melanose do fumante, pigmentação induzida por drogas e tumor neuroectodérmico melanótico da infância. Os resultados encontrados foram essenciais para se estabelecer uma os dados clínicopatológico. Acreditarelação entre se que, diante de poucos estudos retrospectivos de grandes séries de lesões pigmentadas para um melhor entendimento da mucosa oral na literatura, esses resultados podem contribuir a respeito da prevalência desse grupo de lesões. (AU)

Pigmented lesions are uncommon in the oral mucosa and have a wide etiol ogical variety, so studies that investigate the distribution of these lesions are important to improve clinical knowledge, aiding in the diagnosis and treatment of this group of lesions. was to analyze the distribution of pigmented le The aim of this study sions of the oral mucosa Brazilian population. A retrospective descriptive crossin a southeastern sectional study was performed. P igmented lesions of the oral mucosa diagnoses of two oral and maxillofacia were recovered from the files of histopathological l pathology services in the states of São Paulo and Rio de Janeiro, Brazil over a 45year period (19742019). The clinical data and the diagnoses of each case were retrieved and included in a Microsoft Excel® database. From 77.074 lesions diagnosed in this period, 761 (0.99%) represented pigmentated lesions of the oral mucosa, including 351 (46.1%) melanocytic and 410 (53.9%) nonmelanocytic lesions, with a higher incidence in females (73.2%) between the fourth and seventh decades of life. Amalgam tattoo (5 3.6%) represented the most common lesion, followed by melanotic macule (18.3%) and racial pigmentation (10.8%). The buccal mucosa was the most commonly affected site (25.2%), followed by the alveolar ridge (14.5%), and gingiva (11.8%). Other pigmented lesi ons included nevus, post inflammatory pigmentation, melanoma, melanoacanthoma, smoker's melanosis, druginduced pigmentation, and melanotic neuroectodermal tumor of infancy. The results found were essential to establish a relationship between clinical and believed that, given the few retrospective studies of large series of pathological data. It is pigmented lesions of the oral mucosa in the literature, these results may contribute to a better understanding of the prevalence of this group of lesions. (AU)