Longitudinal clinico-pathological data of the progression of oral mucosal melanoma–report of two cases and literature review

Publication date: Available online 28 December 2017
Source:Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
Author(s): Paras B. Patel, John M. Wright, David R. Kang, Yi-Shing Lisa Cheng
Oral mucosal melanoma (OMM) is notorious for having a poor prognosis. Recognition of the early features of OMM by both clinicians and pathologists can play an important role in improving survival. Therefore, the purpose of this report is to increase awareness of the early features of OMM, by presenting two cases with longitudinal clinical and histopathological documentation showing progression of OMM from a deceptively bland pre-malignant (non-invasive) oral melanocytic lesion (POML). Analyzing the clinical and histopathological features of POML in our cases, and those in the literature, we found that the concerning features are: 1) clinically, a pigmented lesion violating the ABCDE criteria or showing multiple recurrences; and 2) histologically, a melanocytic proliferation, in either a lentiginous or pagetoid pattern with or without cellular atypia. Making a diagnosis of POML prospectively is often challenging. Increasing awareness of the clinical and histopathological features, and complete surgical excision of POML is emphasized.



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