Malignant melanoma of the oral cavity is extremely rare, accounting for 0.2% to 8% of all melanomas. Primary gingival malignant melanoma is associated with poor prognosis. We present the clinopathological findings of a case. A 64-year-old woman presented with a hyperplastic-pigmented lesion which was located on the right vestibular maxillary gingiva adjacent to the first molar-canine area. Under local anesthesia an incisional biopsy was taken from the lesion. The pathologic diagnosis of primary malignant melanoma of the gingiva was established after microscopic and immunohistochemical examination, which revealed the neoplastic cells to be positive for HMB-45. A computerized tomography scan on the neck, liver, and lungs revealed no further evidence of disease. A partial right maxillectomy with radical neck dissection was planned. The patient refused the treatment and died after 4 months. In malignant melanoma of the gingiva, survival rates may be increased by early diagnosis and treatment. The dentist must carefully examine periodontal tissues, and pigmented lesions should be biopsied.
Keywords: Diagnosis, gingival disease, mucosal melanoma, oral melanoma, pigmented lesions
