DOI: 10.36347/sjmcr.2024.v12i06.031

Pages: 1093-1097

Melanomas are malignant tumors originating from melanocytic cells, primarily affecting the skin but also found in mucosal regions due to the migration of neural crest cells. Oral cavity melanoma is extremely rare, comprising 0.5% of oral malignancies, predominantly occurring in the maxillary region, particularly the hard palate and gingiva. Compared to cutaneous melanoma, oral melanomas typically manifest in older patients. Clinically, oral melanomas present as macular, nodular, or ulcerated lesions with irregular, asymmetrical borders and varied pigmentation. Symptoms such as tooth mobility, bleeding upon palpation, and delayed healing post-extraction suggest malignancy. Diagnosis is based on histopathological examination of biopsies, complicated by the tumor's architectural and cytological polymorphism, necessitating immunohistochemical studies for confirmation. Key diagnostic biomarkers include S100 protein, HMB45, tyrosinase, Melan A, and MITF. The primary treatment is surgical resection with wide margins and lymph node dissection. Radiotherapy is typically reserved for cases with insufficient surgical margins or as an alternative for elderly patients, while chemotherapy is indicated for metastatic forms. Despite treatment, oral melanomas have a poor prognosis, with a 5-year mortality rate of 95% and median survival of 1-2 years post-diagnosis, primarily due to metastases in the lungs, liver, brain, and bones. In summary, oral melanomas are highly aggressive and recurrent, underscoring the importance of early diagnosis and rapid intervention to improve survival outcomes.