Malignant melanoma is one of the most dangerous forms of neoplasm. A more common lesion than is usually suspected, it comprises about 3 percent of all malignant tumors with about 23 percent occurring in the head and neck area, oronasal and esophageal melanomas counting for 1.8% of these.
Melanomas may occur anywhere in the body and are found in the eye, at the junction of the skin and mucous membrane, and at the site of the body orifices.
The term melanoma was introduced by Carswell in 1838, and the first oral case reported was one described by Weber in 1859 which involved the mucosa of palate.
The criteria for the establishment of the disease as primary in the oral cavity should be based on:
1) Demonstration of malignant melanoma in the oral mucosa.
2) The presence of intraepidermal activity.
3) Inability to demonstrate any other primary site.
The clinical picture of melanoma is described in connection with a report of three cases in the gingiva treated with operation on and irradiation therapy during a six years period 1959-1965.
Case 1
The patient was a 53 years old woman suffering from a pedunculated, soft, blue and reddish ulcerated lesion on the right gingiva. She was treated with partial maxillectomy on both sides and amnion graft, but expired 1year after the operation with metastases to lungs and skeleton.
Case 2
The patient was a 61 years old man suffering from toothache . the clinical finding was a dark green, pigmented necrotic tissue on right upper gingiva. Subtotal resection of right maxilla was performed. The patient is still alive without sings of metastases three years after operation.
Case 3
This 47 years old woman had been suffering from growing lymphglands ´on the right side of neck and showed a darkish pigmented tumor in the buccal gingiva on right side as well as small tumor of same appearance in the right, Rosenmuller.fossa.Initial Cobalt 60 irradiation followed by neck dissection and removal of the rest tumor is planned.
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