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Journal of the American Dental Association

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Original Item ID

DOI: 10.1016/j.adaj.2016.10.005


Background and Overview

Oral melanomas vary in color and morphology and resemble myriad other reactive, benign, or malignant conditions. The authors describe a case report of a patient with a primary oral melanoma that presented as a nonspecific ulcer, which showed nodal metastasis during resection.

Case Description

A 64-year-old man who was examined by his periodontist to assess implant healing had a reddish-purple ulcer of the maxillary mucosa of 3 to 4 weeks duration. The implant was placed 19 weeks earlier in the mandible. The provisional diagnosis was that this ulcer was a traumatic or inflammatory lesion. The clinician biopsied the tissue at the 1-week follow-up appointment, which was identified as melanoma. The patient had a partial maxillectomy and ipsilateral neck dissection. Tissue examination showed nodal metastasis. Two months later, contralateral neck node metastasis was diagnosed and treated.

Conclusions and Practical Implications

In contrast to cutaneous melanoma, oral melanoma has a poor prognosis because of delayed diagnosis. Thorough oral examination at each dental visit may improve the outcome of this fatal condition.


Accepted version. Journal of the American Dental Association, Vol. 148, No. 2 (February 2017): 113-119. DOI. © 2017 Elsevier. Used with permission.

Yeshwant B. Rawal was affiliated with University of Washington at the time of publication.

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