Synchronous metastatic melanoma presenting as gingival and facial swelling: a case report and review of the literature.
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.
Bonan
Paulo Rogério Ferreti
PR
Department of Oral Diagnosis, School of Dentistry, State University of Montes Claros, MG, Brazil. pbonan@yahoo.com
Laranjeira
Anamaria Lima
AL
Martelli-Júnior
Hercílio
H
Guimarães
André Luiz Sena
AL
Vargas
Pablo Agustín
PA
Coletta
Ricardo D
RD
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
D000951:Antigens, Neoplasm; D058965:MART-1 Antigen; C548667:MLANA protein, human; D058950:Melanoma-Specific Antigens; D009363:Neoplasm Proteins; D009418:S100 Proteins