Abstract
A 70-year-old male smoker patient presented lesions of different aspects. In palate, a lesion with pigmented macular area and a normochromic nodule was observed. Another erythematous nodule was evident in the anterior region of the mandible, with diagnostical hypothesis of pyogenic granuloma. Incisional biopsy was performed. Histopathological exam of palate lesion showed a melanocytic malignant neoplasm, evidencing anisokaryosis, cellular and nuclear pleomorphism, mitotic figures, supported by scarce fibrous stroma, while mandible lesion evidenced dense proliferation of fusiform and epithelioid cells, with vesicular nuclei and inconspicuous nucleoli, and eosinophilic cytoplasm with imprecise limits. Innumerable typical and atypical mitoses were also visualized. Immunohistochemical analysis of palate lesion showed positivity for S100, Melan A, and HMB-45, while mandible lesion showed positivity for S100, CKpool AE1/AE3, and negativity for Melan A, HMB-45. Microscopic features corroborated with diagnosis of oral melanoma in palate and amelanotic melanoma in mandible. The patient was referred for oncologic treatment.
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