Amelanotic Malignant Melanoma of Buccal Mucosa: A Case Report

Abstract

Amelanotic melanoma is an atypical variation from pigmented malignant melanoma. The clinical lack of pigment compromises the physician’s clinical diagnosis of the lesion. Presence of certain features like red hair, freckles, photosensitivity, previous history or family history predispose the possibility of occurrence of amelanotic melanoma. As the name suggests, the lesions lack pigmentations clinically and mimic many benign and malignant lesions which can be life threatening and thus, cause a diagnostic challenge. Hence, clinicians are expected to have a high suspicion on such lesions, and also judiciously employ biopsy ,thus eluding the possibility of emerging of lethal lesions. About 50% of head and melanomas occur in the oral cavity. Of all the melanomas, 2% are amelanotic and majority of them occur in oral cavity. These lesions pose a greater degree of threat, because of the possibility of delayed diagnosis. The timely clinical and laboratory diagnosis favours the patient prognosis. No specific aetiologic factors or risk factors have been recognised for oral melanomas. Hereby, the authors present a case of 60-year-old female patients with ulceroproliferative growth in the left cheek region, which was provisionally diagnosed as malignant ulcer, immunohistochemical investigation of the biopsied sections revealed the diagnosis of amelanotic melanoma. The present case report illustrates the need of addition of a panel of Immunohistochemistry (IHC) markers in the routine diagnosis. The application of such panels avoid the delay in diagnosis and scale-up the prognosis.