Intraoral melanoma: long-term follow-up and implication for dental clinicians. A case report and literature review.
Primary intraoral melanoma is a rare neoplasm with a poor prognosis, accounting for 1% to 8% of all melanoma in Europe and the United States. The incidence (12%) and 5-year survival rate (17.4%) are higher in Japan. We report a case of oral lentiginous melanoma in a Japanese-American man who survived disease-free for more than 5 years after surgery, radiation therapy, and chemotherapy but developed chronic mucositis of the palate under the denture in the primary radiated field. This lesion responded to antifungal therapy. Subsequent multiple biopsies ruled out the recurrence of melanoma but demonstrated prolonged melanocytic hyperplasia and focal epithelial atypia. We reviewed clinical differences in oral melanoma reported in the United States and Japanese literature, and describe the wide variety of oral clinical features of postoperative radiation and chemotherapy, as well as the oral tissue changes caused by denture-induced mucositis and candidiasis in such patients. Dental clinicians should conduct a thorough head, neck, and oral follow-up with increased vigilance in patients with a history of prior cancer.
Gu
Gao Man
GM
Department of Oral Medicine, School of Dentistry, University of Washington, Seattle 98195, USA. gmgu@u.washington.edu
Epstein
Joel B
JB
Morton
Thomas H
TH
D000935:Antifungal Agents / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000009:adverse effects; D002180:Candidiasis, Oral / Q000188:drug therapy / Q000209:etiology; D017024:Chemotherapy, Adjuvant / Q000009:adverse effects; D016371:Cranial Irradiation / Q000009:adverse effects; D006801:Humans; D007370:Interferon Type I / Q000009:adverse effects; D016898:Interferon-alpha; D008297:Male; D008545:Melanoma / Q000473:pathology* / Q000628:therapy; D008875:Middle Aged; D009061:Mouth Mucosa / Q000473:pathology / Q000528:radiation effects; D010157:Palatal Neoplasms / Q000473:pathology* / Q000628:therapy; D010159:Palate / Q000473:pathology / Q000528:radiation effects; D018714:Radiotherapy, Adjuvant / Q000009:adverse effects; D011993:Recombinant Fusion Proteins / Q000009:adverse effects; D011994:Recombinant Proteins; D013280:Stomatitis / Q000209:etiology / Q000473:pathology
D000935:Antifungal Agents; D000970:Antineoplastic Agents; D007370:Interferon Type I; D016898:Interferon-alpha; D011993:Recombinant Fusion Proteins; D011994:Recombinant Proteins; C080665:interferon-alpha A-D