Primary melanoma of the oral cavity: a multi-institutional retrospective analysis in Brazil

• Bruno Teixeira Gonçalves Rodrigues ^[4] ; John Lennon Silva Cunha ^[5] ; Danielle Mendes da Silva Albuquerque ^[1] ; Wagner Pinto das Chagas ^[6] ; Nathália de Almeida Freire ^[2] ; Michelle Agostini ^[1] ; Nathalie Henriques Silva Canedo ^[7] ; Ricardo Luiz Cavalcanti de Albuquerque Júnior ^[8] ; Silvia Ferreira de Sousa ^[3] ; Aline Corrêa Abrahão ^[1] ; Mário José Romañach ^[1] ; Oslei Paes de Almeida ^[9] ; Mônica Simões Israel ^[6] ; Bruno Augusto Benevenuto de Andrade ^[6]
  1. [1] Universidade Federal do Rio de Janeiro

     Universidade Federal do Rio de Janeiro

     Brasil

     
  2. [2] Universidade Federal Fluminense

     Universidade Federal Fluminense

     Brasil

     
  3. [3] Universidade Federal de Minas Gerais

     Universidade Federal de Minas Gerais

     Brasil

     
  4. [4] DDS. School of Dentistry, Rio de Janeiro State University (UERJ), RJ, Brazil
  5. [5] DDS, MSc student. Oral Pathology Section, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas (UNICAMP), SP, Brazil
  6. [6] DDS, MSc, Professor. São Leopoldo Mandic Dental School, Rio de Janeiro, RJ, Brazil
  7. [7] DDS, PhD, Professor. Oral Pathology Section, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas (UNICAMP), SP, Brazil
  8. [8] DDS, PhD, Professor. Department of Dentistry, Tiradentes University (UNIT), Aracaju, Sergipe, Brazil
  9. [9] 0DDS, PhD, Professor. Oral Pathology Section, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas (UNICAMP), SP, Brazil

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• Localización: Medicina oral, patología oral y cirugía bucal. Ed. inglesa, ISSN-e 1698-6946, Vol. 26, Nº. 3, 2021
• Idioma: inglés
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• Resumen

  • Melanoma is an aggressive malignant tumor, rarely observed in the oral cavity. The aim of this study was to describe the clinicopathologic features of a series of oral melanomas.

    A retrospective descriptive study was performed. A total of 15,482 biopsy records from two oral and maxillofacial pathology services in Brazil were analyzed. All cases of oral melanomas were reviewed, and clinical, demographic, histopathological data, treatment, and follow-up status were collected. In addition, immunohistochemistry stains (pan-cytokeratin AE1/AE3, vimentin, α-SMA, CD45, S-100 protein, HMB-45, Melan A, and Ki-67) were performed.

    The series comprised of 5 males (71.4%) and 2 females (28.6%), with a mean age of 58.0 ± 9.2 years (range: 45-69 years) and a 2.5:1 male-to-female ratio. The gingiva (n = 3, 42.8%) and hard palate (n = 2, 28.6%) were the most common affected sites, presenting clinically as ulcerated swellings with a brown to black color. Cervical lymph node metastasis was detected in three patients during the first examination. Microscopically, 6 cases (85.7%) were melanotic, and one (14.3%) was amelanotic. Most cases (n = 4, 57.1%) presented a predominance of epithelioid cells. S-100 and HMB-45 were positive in all cases (n = 7, 100.0%). In contrast, only 4 cases (57.1%) were positive for Melan-A. The proliferative index with Ki-67 was high, with labeling index ranging from 70.0% to more than 90% of positive cells. Five patients died from complications of the tumors after a mean follow-up period of 7.8 months.

    Melanoma is an aggressive malignant tumor that rarely occurs in the oral cavity. It occurs mainly in adult and elderly patients and often is diagnosed in advanced stages. The current findings were similar to previous studies and reflected the characteristics of the services from where lesions were retrieved.