MALIGNANT MELANOMA DEFINITION
These are malignant neoplasms arising from the melanocytes of the skin or mucous membrane. The neoplasms commonly have aninitial radial growth phase, which is followed by a vertical growth phase.
MALIGNANT MELANOMA CLINICAL FEATURES:
- Age: Range between 20 to 90years of age.
- Sex: Both sexes are affected but there is a slight male predilection
MALIGNANT MELANOMA PRESENTATION:
- Oral melanomas initiate as macular pigmented focal lesions.
- In melanoma, most of the lesion are pigmented excepting few non-pigmented lesions which are referred to as “amelanotic melanoma”, and which is appeared as “slightly reddish” inflamed-looking areas.
- Surface ulceration is very common and beside this, hemorrhage, paresthesia and superficial fungal infections are often present.
Oral melanomas often cause rapid invasion and extensive destruction of bone, this often results in loosening and exfoliation of the regional teeth in the jaw.
MALIGNANT MELANOMA HISTOPATHOLOGY:
- Microscopically malignant melanoma reveals excessive proliferation of neoplastic melanocytes in the form of large masses within the dermis or epidermis
- These malignant melanocytes often exhibit extensive cellular pleomorphism and nuclear hyperchromatism
- However in some lesions melanin production by the tumor cell can be very little and on few occasions there can be virtually no melanin production.
MALIGNANT MELANOMA DIFFERENTIAL DIAGNOSIS:
- Kaposi’s sarcoma
- Amalgam Tattoo
- Hereditary hemorrhagic telangiectasia
- Oral melanotic macule
MALIGNANT MELANOMA TREATMENT:
The key to the successful treatment of malignant melanoma is early diagnosis as long as lesion remains in the radial growth phase. Radical surgery with prophylactic neck dissection is often advised. Regardless of the treatment modalalities, the tumors in the vertical growth phase often exhibit very poor prognosis.