Unveiling Oral Malignant Melanoma: Clinicopathological Details of a Case

Oral malignant melanoma is a rare tumor of the oral cavity. It is more common among Negros and Japanese people. Initial symptoms are frequently overlooked, resulting in a delayed diagnosis and poor prognosis with a 5-year survival rate. Unlike melanomas in other sites, it is uncommon and thus lacks a well-defined classification system and treatment regimen. The survival rate is mainly correlated with early diagnosis and treatment. A 54-year-old male reported to our department with a de novo fast-growing exophytic proliferative pigmented lesion for six months. After proper radiographic analysis, an incisional biopsy was done which revealed the presence of nests and fascicles of pleomorphic spindle cells with hyperchromatic nuclei and abundant brown pigments rendering it a provisional diagnosis of oral malignant melanoma which was later confirmed by immunohistochemistry (IHC). PET-CT scan revealed widespread metastasis. This article stresses the importance of identification of initial symptoms which are frequently overlooked, resulting in a delayed diagnosis and poor prognosis.