AGGRESSIVE ORAL MELANOMAS: REPORT OF TWO CASES INVOLVING HARD PALATE

Abstract

A 51-year-old woman and a 73-year-old man reported to the hospital presenting extensive dark lesions on the right and left hard palate, respectively. Histopathologic analysis showed fragments of squamous mucosa with large rounded and spindle cell infiltration. Cells presented with a clear cytoplasm, nuclei with granular chromatin, and evident eosinophilic nucleoli. In some foci, there was an abundance of intracytoplasmic brownish pigmentation. Immunohistochemistry reactions presented positive results for MelanA, S-100, HMB45, and SOX-10. The Ki-67 index showed moderate cell proliferation. After the diagnosis of malignant mucosal melanoma, partial maxillectomy was performed in both cases. The male patient underwent postoperative radiotherapy, with no recurrence of the lesion to date. The female patient, however, had cervical metastasis 1 year after surgery. Unilateral lymph node dissection was performed, and the patient is currently undergoing chemotherapy for breast cancer. A 51-year-old woman and a 73-year-old man reported to the hospital presenting extensive dark lesions on the right and left hard palate, respectively. Histopathologic analysis showed fragments of squamous mucosa with large rounded and spindle cell infiltration. Cells presented with a clear cytoplasm, nuclei with granular chromatin, and evident eosinophilic nucleoli. In some foci, there was an abundance of intracytoplasmic brownish pigmentation. Immunohistochemistry reactions presented positive results for MelanA, S-100, HMB45, and SOX-10. The Ki-67 index showed moderate cell proliferation. After the diagnosis of malignant mucosal melanoma, partial maxillectomy was performed in both cases. The male patient underwent postoperative radiotherapy, with no recurrence of the lesion to date. The female patient, however, had cervical metastasis 1 year after surgery. Unilateral lymph node dissection was performed, and the patient is currently undergoing chemotherapy for breast cancer.