title: Synchronous metastatic melanoma presenting as gingival and facial swelling: a case report and review of the literature.
abstract: BACKGROUND
  Metastases to the oral cavity are unusual, and most cases affect the jaws. The clinicopathologic features of a metastatic melanoma involving the mandibular gingiva and facial skin are described.
  
  
  METHODS
  A 42-year-old white woman who had been treated for plantar melanoma 10 years ago showed concomitant nodular lesions in the mandibular gingiva and facial skin. Incisional biopsy and fine needle aspiration cytology were performed in the gingival and facial swelling, respectively.
  
  
  RESULTS
  Radiographs revealed irregular bone erosion and widening of the periodontal ligament space associated with the gingival lesion, whereas cranial computed tomography showed an irregular hyperdense mass associated with the dermal tissue. The histopathologic findings were suggestive of melanoma; immunohistochemical analysis revealed, in both lesions, neoplastic cells strongly positive for S100 and HMB-45 antibodies and weak reactivity for melan-A. The final diagnosis of these lesions was metastatic melanoma, and the patient died before restarting treatment.
  
  
  CONCLUSIONS
  To the best of our knowledge, this is the first English-language report of metastatic melanoma affecting the gingiva and facial skin concomitantly. The intraoral involvement of disseminated melanoma indicates a very poor prognosis, as confirmed by the current case.
authors.affiliation: Department of Oral Diagnosis, School of Dentistry, State University of Montes Claros, MG, Brazil. pbonan@yahoo.com
authors.forename: Paulo Rogério Ferreti
authors.initials: PR
authors.lastname: Bonan
authors.forename: Anamaria Lima
authors.initials: AL
authors.lastname: Laranjeira
authors.forename: Hercílio
authors.initials: H
authors.lastname: Martelli-Júnior
authors.forename: André Luiz Sena
authors.initials: AL
authors.lastname: Guimarães
authors.forename: Pablo Agustín
authors.initials: PA
authors.lastname: Vargas
authors.forename: Ricardo D
authors.initials: RD
authors.lastname: Coletta
mesh_terms: D000328:Adult; D000951:Antigens, Neoplasm / Q000032:analysis; D001706:Biopsy; D044963:Biopsy, Fine-Needle; D005153:Facial Neoplasms / Q000556:secondary*; D017809:Fatal Outcome; D005260:Female; D005534:Foot Diseases / Q000473:pathology; D005887:Gingival Neoplasms / Q000556:secondary*; D006801:Humans; D058965:MART-1 Antigen; D008545:Melanoma / Q000276:immunology / Q000473:pathology / Q000556:secondary*; D058950:Melanoma-Specific Antigens; D009363:Neoplasm Proteins / Q000032:analysis; D009418:S100 Proteins / Q000032:analysis; D014057:Tomography, X-Ray Computed
chemical_list: D000951:Antigens, Neoplasm; D058965:MART-1 Antigen; C548667:MLANA protein, human; D058950:Melanoma-Specific Antigens; D009363:Neoplasm Proteins; D009418:S100 Proteins