Synchronous metastatic melanoma presenting as gingival and facial swelling: a case report and review of the literature.

BACKGROUND

Metastases to the oral cavity are unusual, and most cases affect the jaws. The clinicopathologic features of a metastatic melanoma involving the mandibular gingiva and facial skin are described.

METHODS

A 42-year-old white woman who had been treated for plantar melanoma 10 years ago showed concomitant nodular lesions in the mandibular gingiva and facial skin. Incisional biopsy and fine needle aspiration cytology were performed in the gingival and facial swelling, respectively.

RESULTS

Radiographs revealed irregular bone erosion and widening of the periodontal ligament space associated with the gingival lesion, whereas cranial computed tomography showed an irregular hyperdense mass associated with the dermal tissue. The histopathologic findings were suggestive of melanoma; immunohistochemical analysis revealed, in both lesions, neoplastic cells strongly positive for S100 and HMB-45 antibodies and weak reactivity for melan-A. The final diagnosis of these lesions was metastatic melanoma, and the patient died before restarting treatment.

CONCLUSIONS

To the best of our knowledge, this is the first English-language report of metastatic melanoma affecting the gingiva and facial skin concomitantly. The intraoral involvement of disseminated melanoma indicates a very poor prognosis, as confirmed by the current case.