Abstract
Oral melanoacanthoma (MA) is a rare pigmented lesion characterized by hyperplasia of spinous keratinocytes and dendritic melanocytes that usually affects the buccal mucosa, lip, palate, and gingiva of adult women. An otherwise healthy 58-year-old female patient presented a diffuse pigmented dark brown lesion on the right buccal mucosa measuring 5 cm in greatest diameter. The clinical differential diagnoses included melanocytic macule, melanocytic nevus, and melanoacanthoma. Gross features included a whitish soft tissue showing superficial pigmented deposits. The microscopic evaluation showed marked acanthosis of parakeratinized stratified squamous epithelium of the oral cavity, which was associated with heavily pigmented dendritic melanocytes in the basal and suprabasal layers of the epithelium. The lamina propria presented melanophages and lymphocytic infiltrate containing eosinophils. The biopsy site healed completely without complications. Oral clinicians and pathologists should consider oral melanoacanthoma in the clinical differential diagnosis of oral pigmented lesions.
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