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Published on: March 8, 2022
PRAME immunohistochemistry is useful in the diagnosis of oral malignant melanoma
Daniel Hovander1, Joshua Allen1, Dolphine Oda2
1University of Washington School of Dentistry, Seattle, WA 98195, USA.
Objectives:
While the incidence of cutaneous melanoma has dramatically increased in recent years, oral malignant melanoma (OMM) remains a rare form of noncutaneous melanoma with poor survival. PRAME (PReferentially expressed Antigen in MElanoma) is reported to have diagnostic and some prognostic utility in cutaneous melanomas and some head and neck malignancies. We sought to explore the diagnostic utility of PRAME in OMM.
Methods:
A total of ten specimens from eight unique cases of OMM were identified from the Oral Pathology Biopsy Service (OPBS) at University of Washington School of Dentistry between 2005 and 2019. For all cases, standard histology and immunohistochemistry stains were performed, including a stain against PRAME. The diagnoses were reviewed and confirmed by two pathologists. Clinical and epidemiologic features were described.
Results:
Patient ages ranged from 55 to 82. The group consisted of five males and three females. All eight cases were located on the hard palate. Six cases represented invasive melanoma while two were early melanoma in situ. PRAME immunohistochemistry was successfully performed on seven of eight cases: six were positive (86%), one was negative (14%) and one case lacked sufficient tissue for staining.
Conclusions:
Our results suggest that PRAME immunohistochemistry may be useful in the diagnosis of OMM, including early melanoma in situ. Further studies with clinical follow-up and a larger number of cases are needed to explore prognostic value as well as the ability to distinguish between benign, intermediate and malignant melanocytic proliferations of the oral cavity.
Insights
PRAME immunohistochemistry shows promise for diagnosing oral malignant melanoma (OMM), even in early stages. Further research is needed to confirm its prognostic value in distinguishing between benign and malignant oral lesions.
Area of Science:
- Oral pathology
- Oncology
- Immunohistochemistry
Background:
- Oral malignant melanoma (OMM) is rare with poor survival rates.
- PRAME (PReferentially expressed Antigen in MElanoma) shows diagnostic utility in cutaneous melanomas.
- The diagnostic utility of PRAME in OMM requires further investigation.
Discussion:
- PRAME immunohistochemistry was performed on seven of eight OMM cases.
- Six of seven cases (86%) tested positive for PRAME.
- One case tested negative, and one lacked sufficient tissue for staining.
Key Insights:
- PRAME immunohistochemistry demonstrated positivity in 86% of evaluable oral malignant melanoma cases.
- The findings suggest PRAME may aid in diagnosing OMM, including early melanoma in situ.
- Histological review confirmed six invasive and two in situ OMM cases.
Outlook:
- Further studies with larger cohorts and clinical follow-up are necessary.
- Investigate PRAME's prognostic value in OMM.
- Explore PRAME's ability to differentiate benign, intermediate, and malignant oral melanocytic lesions.
