Amelanotic melanoma presented as an ulcerated, exophytic mass on the mandibular ridge

Wilson Alejandro Delgado Azañero; Jaime Orlando Huamaní Parra; Leopoldo Victor Meneses Rivadeneira; Claudia Gabriela Ruiz Rojas; Luciano Hermios Matos Valdez; Katman Bear Toledo Sanchez

doi:10.5327/2525-5711.352

Authors

Wilson Alejandro Delgado Azañero Universidad Peruana Cayetano Heredia, Faculty of Stomatology, Buccomaxillofacial, Department of Medicine and Surgery – Lima, Perú. https://orcid.org/0000-0001-8116-2375
Jaime Orlando Huamaní Parra Universidad Peruana Cayetano Heredia, Faculty of Stomatology, Buccomaxillofacial, Department of Medicine and Surgery – Lima, Perú. https://orcid.org/0000-0002-6191-9331
Leopoldo Victor Meneses Rivadeneira Universidad Peruana Cayetano Heredia, Faculty of Stomatology, Buccomaxillofacial, Department of Medicine and Surgery – Lima, Perú. https://orcid.org/0000-0003-0905-506X
Claudia Gabriela Ruiz Rojas Universidad Peruana Cayetano Heredia, Faculty of Stomatology, Buccomaxillofacial, Department of Medicine and Surgery – Lima, Perú. https://orcid.org/0009-0002-4213-9150
Luciano Hermios Matos Valdez Universidad Peruana Cayetano Heredia, Faculty of Stomatology, Buccomaxillofacial, Department of Medicine and Surgery – Lima, Perú. https://orcid.org/0000-0002-5522-3186
Katman Bear Toledo Sanchez Universidad Peruana Cayetano Heredia, Faculty of Stomatology, Buccomaxillofacial, Department of Medicine and Surgery – Lima, Perú. https://orcid.org/0000-0002-9082-1800

DOI:

https://doi.org/10.5327/2525-5711.352

Keywords:

Mucosal melanoma, Amelanotic melanoma, Oral tumor, Immunohistochemestry, Melanocytes

Abstract

Amelanotic melanomas are aggressive neoplasms that are exceedingly rare in the oral cavity. We report the case of a 74-year-old woman who presented with a large, ulcerated, exophytic mass on the edentulous lower alveolar ridge. Histological examination revealed two distinct cell populations: epithelioid cells arranged in an alveolar pattern and spindle-shaped cells arranged in fascicles, both exhibiting prominent nucleoli. Immunohistochemical staining was performed using S-100, SOX10, Melan-A, HMB-45, PRAME, and Ki-67. S-100 and SOX10 showed strong positivity, PRAME was focally positive, and the Ki-67 index was high. Melan-A and HMB-45 were negative. Due to the absence of clinical and histological pigmentation, amelanotic melanoma can be easily overlooked. Therefore, any rapidly growing, ulcerated mass in the oral cavity should raise suspicion for this diagnosis.

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