A rare case of malignant melanoma
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Malignant melanoma is a rare aggressive neoplasm, which represents 1-2% of oral malignancies. One such case has been presented in the Journal of Dental Health Oral Disorders & Therapy.

A 65-year-old male patient reported to the department of oral medicine and radiology with chief complain of pain and swelling in upper right back tooth region since one months, started as pin point lesion, progressed gradually to attend present size and shape. On clinical examination, a solitary diffuse swelling was present on the right posterior region maxillary teeth region i.r.t. 16- 18, measuring about 3x2cm oval in shape, extending from distal 15 to about 1cm before the maxillary tuberosity. The overlying mucosa was dark blue in color and without any associated secondary changes.

There was multiple area of brown pigmentation having variable sizes ranging from pin point to about 1 mm in greatest dimension throughout the soft palate area. On palpation the lesion was smooth, non-tender, well defined, firm to hard in consistency with induration of the posterior margins.

Extra oral examination revealed solitary right sub mandibular lymph node was palpable; a solitary cervical lymph node was also palpable on right side which was mobile, non-tender and firm.

Pigmented nodular growth was present with color of overlying mucosa was bluish brown extending from edentulous portion of 15 -18, oval in shape, obliterating right buccal vestibule. Based on clinical appearance, the provisional diagnosis was malignant melanoma while pigmented lesions were like Hemangioma, AV malformation and melanoma were considered under differential diagnosis.

Blood investigations did not reveal any significant findings but radiographic features revealed ill-defined radiopaque area involving posterior right alveolus region posterior to 15 extending up to maxillary tuberosity with ragged border.

Incisional biopsy of the lesion was performed and sent for histopathological examination. Haematoxylin and eosin-stained sections showed Para keratinized stratified squamous epithelium and connective tissue stroma.

Connective tissue stroma was comprised of sheets and island of neoplastic cells. Lesional cells consisted of round to polygonal and spindle shape cells. Anisocytosis and anisonucleosis along with increased number of mitotic figures were observed. Neoplastic cells consisted of hyperchromatic nucleus. The lesion was diagnosed as melanoma.

Read in detail here: https://medcraveonline.com/JDHODT/JDHODT-09-00370.pdf