A case of malignant melanoma from an unknown primary site that extensively invaded the mandibular bone

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  • MOTOHASHI Masayuki
    Department of Oral and Maxillofacial Surgery, Division of Oral Pathogenesis and Disease Control, Asahi University School of Dentistry
  • SUMITOMO Shinichiro
    Department of Oral and Maxillofacial Surgery, Division of Oral Pathogenesis and Disease Control, Asahi University School of Dentistry
  • MURAMATSU Yasunori
    Department of Oral and Maxillofacial Surgery, Division of Oral Pathogenesis and Disease Control, Asahi University School of Dentistry
  • TANAKA Shiro
    Department of Oral and Maxillofacial Surgery, Division of Oral Pathogenesis and Disease Control, Asahi University School of Dentistry
  • NAGAYAMA Motohiko
    Department of Oral Pathology, Division of Oral Pathogenesis and Disease Control, Asahi University School of Dentistry
  • SHIKIMORI Michio
    Department of Oral and Maxillofacial Surgery, Division of Oral Pathogenesis and Disease Control, Asahi University School of Dentistry

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Other Title
  • 下顎骨内に広範に進展した原発不明悪性黒色腫の1例
  • カガクコツ ナイ ニ コウハン ニ シンテン シタ ゲンパツ フメイ アクセイ コクショク シュ ノ 1レイ

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Abstract

To our knowledge, a case of primary oral malignant melanoma (MM) invading mainly the jaw has yet to be reported. We report a case of MM that spread widely in the mandibular medullary cavity with limited involvement of the mucosa. <BR>A 40-year-old woman visited our hospital because of mobility of the lower right second molar. Initial examination showed that the second molar floated, and the gingiva was pale purple-blue. An X-ray film showed a diffuse radiolucent area from the premolar to the ramus of the right mandible. The diagnosis of a biopsy specimen was MM, and no distant metastasis was detected on whole body examination. A wide tumor resection with radical neck dissection and immediate reconstruction were performed. Histopathological examination of the specimen revealed MM invading mainly the mandibular bone marrow; however, the primary site remained unknown. DAV-Feron therapy was given postoperatively. Three months later, left cervical lymph node metastasis was detected, and neck dissection was performed. Three years after the first visit, a metastatic lesion in the pleural space was excised by thoracosopic surgery. Ten courses of DAV-Feron therapy were completed, and the patient is now under observation.

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