Gingival Melanoma
An otherwise healthy 45-year-old man presented with a 4-week history of nonpainful discoloration of the maxillary gingiva. He had no history of pigmented skin lesions. Intraoral examination showed areas of the gingiva that were black. The lesion was a pigmented macule, 1.5 cm by 4 cm in greatest dimension, with asymmetric and irregular borders and colors. Histopathological examination revealed an infiltrating lentiginous melanoma. Oral melanoma is a rare neoplasm. Exposure to the sun is clearly linked to cutaneous melanoma but is not clearly associated with oral melanoma. The patient underwent partial maxillectomy with 2-cm margins, but he declined adjuvant radiotherapy and chemotherapy. No pathologic lymph nodes were found. At follow-up 6 months after surgery, there were no signs of tumor recurrence. Wei Guo, M.D. The Ninth People's Hospital of Shanghai Jiao Tong University, Shanghai, China Xin Wang, M.D. Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi, Jiangsu, China source: nejm.org