A Blackish Gingiva Revealing a Metastatic Melanoma of the Oral Mucosa

Abstract

Background and Objective: Malignant melanoma is the most aggressive skin cancer because it has very strong metastatic power. Endobuccal localization is very rare. Its discovery is often made in the late stage, which leads to a consistently pessimistic diagnostic. We report a case of palatal melanoma at the metastatic stage. Case Report: A 43-year-old woman presented left lateral cervical swelling associated with dyspnea for 5 months. She had regularly taken chewing tobacco for 4 years and had developed blackish gums. The endobuccal examination showed a blackish non-haemorrhagic swelling of 5 cm of the long axis, located at the level of the palatal vault, associated with pigmentation in teeth 21, 22, and 23. The anatomopathological examination confirmed the melanoma. The spreading assessment revealed pleural and hepatic metastasis. The proposed treatment was palliative treatment. The patient died 2 months later. Conclusion: Melanoma of the oral mucosa is a very aggressive tumor. The scarcities of dental care among the Malagasy people exacerbate the delay in diagnosis. Its management is still challenging in Madagascar.