Welcome back to my melanoma blog. Melanoma is primarily known as a type of skin cancer appearing on a patient’s body, which is what most of my posts on this blog have focused on. The New England Journal of Medicine recently detailed the story of a 45-year old Chinese patient who developed a rare type of melanoma in his upper gums.
According to Wei Guo, M.D. and Xin Wang, M.D. of Shanghai and Jiangsu respectively, an otherwise healthy 45-year old man presented with non-painful discoloration of the maxillary gingival. He had no previous history of pigmented skin lesions and said the discoloration had been present for four weeks. Upon further intraoral examination, the lesion was identified as a pigmented macule, 1.5 cm x 4 cm, with asymmetry, multiple colors, and irregular borders. You will hopefully recognize many of these traits from the ABCDE Detection Criteria I introduced in an earlier blog post. Doctors completed a partial removal (maxillectomy) with 2-cm margins but the patient declined radiotherapy and chemotherapy. In a follow-up consultation six months after the partial maxillectomy, doctors reported no signs of tumor recurrence.
In an article appearing on LiveScience.com, Emory University Professor of Pathology Dr. Susan Muller provided additional background on melanoma in the mouth. She completed a study in 2008 investigating the number of melanoma patients treated at Emory University and affiliated hospitals, finding that just eight patients presented with melanoma in the mouth over a 20-year period.
Muller explained that melanoma attacks melanocytes, the cells that produce pigments that influence skin color. She added, “at this point, we don’t know, first, why there are melanocytes in the mouth, and second, what makes those cells go bad and become malignant,” before concluding that patients don’t necessarily have to examine their mouth for possible melanoma, as the risk of oral cancer is much higher. Still, the case serves as a good reminder that melanoma can also occur in the oral cavity.
To view the full article from Live Science, click here: http://www.livescience.com/40304-rare-melanoma-in-gums.html
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