PDF(Pubmed)
Abstract：
Primary melanoma of the oral cavity is extremely rare, accounting for 0.2-8% of all melanomas. Lesions arising from mucosal melanocytes occur most frequently on the gingiva or palate. Mucosal melanomas carry a worse prognosis than cutaneous melanomas. Very few studies have been published due to rarity of disease. 46 year old lady presented with black colored lesion over left side of her tongue for 6 weeks. On examination there was 3 × 2.5 cm black colored patch over left lateral part of tongue in middle 1/3rd, not crossing midline. Tip and base of tongue were free. Biopsy was suggestive of malignant melanoma of tongue. Patient underwent surgery (wide local excision of left lateral border of tongue lesion + left selective neck dissection). Final Histopathological report revealed malignant melanoma of tongue with all margins free, Depth of invasion 3 mm, Lympho-vascular invasion present, and no perineural invasion, left level III cervical lymph node metastases. Patient thus received adjuvant RT. Immunotherapy was also advised in multidisciplinary clinic, but patient was non-compliant. Early diagnosis will be promoted by careful oral examination and early biopsy of pigmented and non-pigmented masses. Early diagnosis and treatment will improve the prognosis of patients with oral malignant melanoma.
摘要：
口腔原发性黑色素瘤极为罕见，占所有黑色素瘤的0.2-8%。粘膜黑素细胞引起的病变最常见于牙龈或腭。粘膜黑素瘤的预后比皮肤黑素瘤差。由于罕见的疾病，很少有研究发表。46岁的女士在舌头左侧出现黑色病变，持续6周。检查时舌左侧中部1/3处有3×2.5cm黑色斑点，不能越过中线.舌尖和舌根是自由的。活检提示舌恶性黑色素瘤。患者接受了手术（舌病变左外侧缘局部广泛切除+左选择性颈清扫术）。最终组织病理学报告显示舌恶性黑色素瘤，所有边缘均无，侵入深度3mm,存在淋巴血管侵犯，没有神经周侵犯,左III级颈淋巴结转移。因此患者接受佐剂RT。多学科诊所也建议免疫疗法，但患者不合规。通过仔细的口腔检查和色素性和非色素性肿块的早期活检将促进早期诊断。早期诊断和治疗将改善口腔恶性黑色素瘤患者的预后。
