Malignant melanoma of the oral cavity showing satellitism

Oral malignant melanoma is a rare aggressive neoplasm of melanocytic origin, usually found on the hard palate and gingiva, and representing 0.2-8% of all melanomas. Unfortunately, oral mucosal melanomas have by far the worst prognosis, and therefore early detection is indispensable for improving their prognosis. Histopathological examination of any pigmented lesion is essential to rule out this lethal entity. Computed tomography is of help for assessing both the extent of the lesion and the presence of regional metastasis to the lymph nodes. Malignant melanoma cells stain positively with antibodies against HMB-45, S-100 protein and vimentin, and so immuno-histochemistry can play a crucial role in evaluating the depth of invasion and location of metastasis. The presence of satellite/in transit lesions is an important factor affecting prognosis. Here we report a 30-year-old female patient with malignant melanoma of the gingiva and hard palate with a satellite lesion, highlighting the role of various diagnostic tools in its detection, and the prognosis associated with satellitism.