Primary Oral Malignant Melanoma-A Clinicopathological Study of 6 Cases

Abstract

Oral malignant melanomas (OMMs) are a rare entity, comprising less than 1% of all malignant melanomas. Six patients with an OMM diagnosed and/or treated in our institute during the period from 1988 to 2003 were analyzed in this study. There were 4 female and 2 male patients. The mean age of the 6 patients at the time of diagnosis was 64 years. Of the 6 OMMs, 4 occurred on the hard palate, 1 on both the hard palate and maxillary gingiva, and 1 on the mandibular gingiva. The greatest dimension of the lesions ranged from 1.5 to 8cm with a mean of 4cm. The more-common clinical symptoms and signs were black-pigmented tumors with ulceration, pain, or bleeding. Of the 5 patients whose dental status was available, 4 had either a denture or a bridge near or impinging on the tumor. At the time of initial presentation, 3 patients were in clinical stage Ⅰ (localized disease), and the other 3 were in clinical stage Ⅱ (OMM with regional lymph node metastasis). Two patients who received surgical excision of the primary OMM with or without modified radical neck dissection survived for 25 and 14 months, respectively; 2 patients who were treated by chemotherapy with or without radiotherapy survived 54 and 48 months, respectively; and the remaining 2 patients who received no treatment survived 8 and 2 months, respectively. We concluded that OMMs occur more often in the sixth and seventh decades. The more-common affected sites are the hard palate and maxillary gingiva. The more-frequent clinical presentation is a pigmented mass. The mean survival of our 6 OMM patients was 25 months. Certain treatments do prolong the life of OMM patients.