title: A rare case of amelanotic malignant melanoma in the oral region: Clinical investigation and immunohistochemical study.
abstract: Amelanotic malignant melanoma (AMM) is rare in the oral region. The present study examined the clinical features of this tumor in an attempt to establish diagnostic criteria. The expression of three melanocytic differentiation markers, HMB-45, S-100 and Melan-A, was also measured in primary oral AMMs in order to determine whether the markers could be used to diagnose primary oral AMMs and to find out which marker was the most sensitive. It may be particularly difficult to correctly diagnose AMM that lacks a radial growth phase without immunohistochemical assistance. In the present study, mixtures of polygonal and spindle cells at different ratios were observed in the tumors with and without a radial growth phase. Immunohistochemistry was used to examine the HMB-45, S-100 and Melan-A expression in the formalin-fixed paraffin-embedded specimens of primary oral AMMs. Comparison of staining intensities (SIs) and labeling indices (LIs) of the markers was also performed. The immunostaining results revealed that the SI of Melan-A was significantly higher than that of S-100 (P=0.0011). HMB-45, S-100 and Melan-A also exhibited high positive rates and LIs in AMMs and, therefore, may be good markers for the immunohistochemical diagnosis of primary oral AMMs. Furthermore, Melan-A may be a more sensitive marker than S-100 and HMB-45, as it has a higher SI.
authors.affiliation: Second Department of Oral and Maxillofacial Surgery, Osaka Dental University, Chuo-ku, Osaka 540-0008, Japan.
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Ohnishi
authors.affiliation: Second Department of Oral and Maxillofacial Surgery, Osaka Dental University, Chuo-ku, Osaka 540-0008, Japan.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Watanabe
authors.affiliation: Second Department of Oral and Maxillofacial Surgery, Osaka Dental University, Chuo-ku, Osaka 540-0008, Japan.
authors.forename: Tomoko
authors.initials: T
authors.lastname: Fujii
authors.affiliation: Second Department of Oral and Maxillofacial Surgery, Osaka Dental University, Chuo-ku, Osaka 540-0008, Japan.
authors.forename: Noriko
authors.initials: N
authors.lastname: Sunada
authors.affiliation: Second Department of Oral and Maxillofacial Surgery, Osaka Dental University, Chuo-ku, Osaka 540-0008, Japan.
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Yoshimoto
authors.affiliation: Second Department of Oral and Maxillofacial Surgery, Osaka Dental University, Chuo-ku, Osaka 540-0008, Japan.
authors.forename: Hirohito
authors.initials: H
authors.lastname: Kubo
authors.affiliation: Department of Oral Pathology, Osaka Dental University, Hirakata-shi, Osaka 573-1121, Japan.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Wato
authors.affiliation: Second Department of Oral and Maxillofacial Surgery, Osaka Dental University, Chuo-ku, Osaka 540-0008, Japan.
authors.forename: Kenji
authors.initials: K
authors.lastname: Kakudo
keywords: HMB-45; Melan-A; S-100; amelanotic malignant melanoma; immunohistochemistry; oral