Oral melanoma: Relevance to the dental team members

Oral melanomas vary in color and morphology and resemble myriad other reactive, benign, or malignant conditions. The authors describe a case report of a patient with a primary oral melanoma that presented as a nonspecific ulcer, which showed nodal metastasis during resection.

A 64-year-old man who was examined by his periodontist to assess implant healing had a reddish-purple ulcer of the maxillary mucosa of 3 to 4 weeks duration. The implant was placed 19 weeks earlier in the mandible. The provisional diagnosis was that this ulcer was a traumatic or inflammatory lesion. The clinician biopsied the tissue at the 1-week follow-up appointment, which was identified as melanoma. The patient had a partial maxillectomy and ipsilateral neck dissection. Tissue examination showed nodal metastasis. Two months later, contralateral neck node metastasis was diagnosed and treated.

In contrast to cutaneous melanoma, oral melanoma has a poor prognosis because of delayed diagnosis. Thorough oral examination at each dental visit may improve the outcome of this fatal condition.