Abstract
A 76-year-old white man was referred for a nodular lesion in the right hard palate noticed about 8 months prior to presentation. The lesion caused difficulty in fitting complete dentures, and an ulcerated surface caused intense bleeding after removal of the prosthesis. Intraoral examination revealed a black, 3 × 2 cm wide nodule exhibiting purple-colored bleeding areas, pedunculated and with well-defined borders and a lobulated surface. The differential diagnosis included angiosarcoma and melanoma. Incisional biopsy and histopathologic analysis showed a malignant neoplasm with polyhedral and epithelioid cells, with eccentric nuclei and brown pigmentation in the cytoplasm. These cells finally changed to multinucleated forms and invaded the connective tissue. With a final diagnosis of melanoma, a surgical procedure was suggested. Oral melanomas are a rare entity in the oral mucosa, with poor prognosis as a result of delay in diagnosis, especially in older people.
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