Report of a recurrent tongue malignant melanoma and review of literature

Primary oral mucosal melanoma is a rare disease. Etiopathogenesis of oral mucosal melanoma (OMM) is inadequately understood. The prognosis of OMM is very poor . Due to its low incidence and late recognition, the optimal treatment modality is not well established. Surgery with free margins is the mainstay of treatment.

Treatment of recurrent mucosal melanoma of the oral cavity with topical imiquimod and pembrolizumab achieves complete histopathologic remission

Mucosal melanomas constitute a subtype of melanoma with less effective treatments than cutaneous melanomas. We present a case of oral mucosal melanoma that recurred despite multiple resections and adjuvant temozolomide. Treatment with topical imiquimod combined with pembrolizumab achieved remission. A 56-year-old woman presented with a pigmented mass on her left anterior hard palate. Biopsy revealed malignant melanoma. The patient had resection with neck dissection with 3 months of adjuvant temozolomide due to positive margins. Malignant melanoma involving the hard palate recurred 1 year later requiring additional resection. Two years later, two additional pigmented lesions were found; further resections were deferred due to expected morbidity. Following 6 weeks of topical imiquimod treatment, the lesions shrunk significantly. Adjuvant pembrolizumab was added and complete histopathologic remission was observed in 6 months. The patient remained in remission for 4 years before new melanoma in situ was diagnosed, requiring five additional months of imiquimod. As of April 2021, there is no clinical evidence of melanoma. There are limited reports of oral melanoma treated with topical imiquimod. Here, imiquimod administered in combination with pembrolizumab achieved complete pathologic response.

Treatment Modalities of Recurrent Oral Mucosal Melanoma In Situ

Oral mucosal melanoma (OMM) represents an extremely rare entity that is associated with a poor prognosis due to late diagnosis and early metastasis. Here, extensive surgical therapy is the therapy of choice. In contrary, for OMM in situ, the respective therapeutical recommendations are lacking. In this case report, treatment modalities of an OMM in situ of the palate, including the maxillary alveolar process, are reported. The tumor relapsed twice despite adequate surgical therapy and reconstruction. Therefore, irradiation was performed as an adjuvant therapy. At a follow-up of two years, the patient was free from recurrences.

Expression of S100, HMB45 and Melan A in Oral Mucosal Melanoma

Background: Malignant melanomas of the oral cavity are rare tumours. The diagnosis of mucosal melanoma can be difficult especially when it presents itself in its amelanotic form. Methodology: An electronic search was carried out on Pubmed and Medline database to find studies addressing this question published between Jan 2001 and April 2020. Multiple studies are done to determine the staining and positivity of the above mentioned three markers were found. A total of 4 studies were finally selected for this review which tried to determine the efficiency of these three markers in the diagnosis of oral mucosal melanomas. Results: The patient’s data that stained positive S100, HMB45 and Melan A from 4 studies were selected. Conclusion: S100 continues to remain the most sensitive marker for melanoma with its promising ability in diagnosing the desmoplastic variant. The lack of specificity is still a drawback of S100.