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Spindle Cell Amelanotic Lesion of the Tongue: a Diagnostic and Therapeutic Challenge

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Abstract

Melanomas occurring in the tongue are rarer, and when nonpigmented they are often misdiagnosed as squamous cell carcinoma. We report a 50-year-old woman who presented with a 3 × 2 cm soft swelling of mucosal color on the right lateral border of the tongue. The patient had multiple recurrences and was treated by radical radiotherapy, was operated thrice and received adjuvant 5 MIU interferon weekly. During the last surgery, she developed multiple cerebral infarcts and died on the fifth postoperative day. Oral amelanotic melanoma is a very aggressive and potential lethal tumor that often presents as diagnostic dilemma.

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References

  1. Pandey M, Mathew A, Iype EM, Sebastian P, Abraham EK, Nair KM (2002) Primary malignant mucosal melanoma of the head and neck region: pooled analysis of 60 published cases from India and review of literature. Eur J Cancer Prev 11(1):3–10

    Article  CAS  PubMed  Google Scholar 

  2. Gondivkar SM, Indurkar A, Degwekar S, Bhowate R (2009) Primary oral malignant melanoma–a case report and review of the literature. Quintessence Int 40(1):41–46

    PubMed  Google Scholar 

  3. McLean N, Tighiouart M, Muller S (2008) Primary mucosal melanoma of the head and neck. Comparison of clinical presentation and histopathologic features of oral and sinonasal melanoma. Oral Oncol 44(11):1039–1046

    Article  PubMed  Google Scholar 

  4. Meleti M, Leemans CR, de Bree R, Vescovi P, Sesenna E, van der Waal I (2008) Head and neck mucosal melanoma: experience with 42 patients, with emphasis on the role of postoperative radiotherapy. Head Neck 30(12):1543–1551

    Article  PubMed  Google Scholar 

  5. Wagner M, Morris CG, Werning JW, Mendenhall WM (2008) Mucosal melanoma of the head and neck. Am J Clin Oncol 31(1):43–48

    Article  PubMed  Google Scholar 

  6. Manolidis S, Donald PJ (1997) Malignant mucosal melanoma of the head and neck: review of the literature and report of 14 patients. Cancer 80(8):1373–1386

    Article  CAS  PubMed  Google Scholar 

  7. Gwosdz C, Scheckenbach K, Lieven O, Reifenberger J, Knopf A, Bier H, Balz V (2006) Comprehensive analysis of the P53 status in mucosal and cutaneous melanomas. Int J Cancer 118(3):577–582

    Article  CAS  PubMed  Google Scholar 

  8. Takagi R, Nakamoto D, Mizoe JE, Tsujii H (2007) LOH analysis of free DNA in the plasma of patients with mucosal malignant melanoma in the head and neck. Int J Clin Oncol 12(3):199–204

    Article  CAS  PubMed  Google Scholar 

  9. Marani C, Alvino E, Caporali S, Vigili MG, Mancini G, Rahimi S (2007) DNA mismatch repair protein expression and microsatellite instability in primary mucosal melanomas of the head and neck. Histopathology 50(6):780–788

    Article  CAS  PubMed  Google Scholar 

  10. Bradley PJ (2006) Primary malignant mucosal melanoma of the head and neck. Curr Opin Otolaryngol Head Neck Surg 14(2):100–104

    Article  PubMed  Google Scholar 

  11. Yu CH, Chen HH, Liu CM, Jeng YM, Wang JT, Wang YP, Liu BY, Sun A, Chiang CP (2005) HMB-45 may be a more sensitive maker than S-100 or melan-A for immunohistochemical diagnosis of primary oral and nasal mucosal melanomas. J Oral Pathol Med 34(9):540–545

    Article  PubMed  Google Scholar 

  12. Morris LG, Wen YH, Nonaka D, DeLacure MD, Kutler DI, Huan Y, Wang BY (2008) PNL2 melanocytic marker in immunohistochemical evaluation of primary mucosal melanoma of the head and neck. Head Neck 30(6):771–775

    Article  PubMed  Google Scholar 

  13. Satzger I, Schaefer T, Kuettler U, Broecker V, Voelker B, Ostertag H, Kapp A, Gutzmer R (2008) Analysis of C-KIT expression and KIT gene mutation in human mucosal melanomas. Br J Cancer 99(12):2065–2069

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  14. Penel N, Mallet Y, Mirabel X, Van JT, Lefebvre JL (2006) Primary mucosal melanoma of head and neck: prognostic value of clear margins. Laryngoscope 116(6):993–995

    Article  PubMed  Google Scholar 

  15. McKinnon JG, Kokal WA, Neifeld JP, Kay S (1989) Natural history and treatment of mucosal melanoma. J Surg Oncol 41(4):222–225

    Article  CAS  PubMed  Google Scholar 

  16. Prasad ML, Patel S, Hoshaw-Woodard S, Escrig M, Shah JP, Huvos AG, Busam KJ (2002) Prognostic factors for malignant melanoma of the squamous mucosa of the head and neck. Am J Surg Pathol 26(7):883–892

    Article  PubMed  Google Scholar 

  17. Nakashima JP, Viegas CM, Fassizoli AL, Rodrigues M, Chamon LA, Silva JH, Dias FL, Araujo CM (2008) Postoperative adjuvant radiation therapy in the treatment of primary head and neck mucosal melanomas. ORL J Otorhinolaryngol Relat Spec 70(6):344–351

    Article  PubMed  Google Scholar 

  18. Krengli M, Masini L, Kaanders JH, Maingon P, Oei SB, Zouhair A, Ozyar E, Roelandts M, Amichetti M, Bosset M, Mirimanoff RO (2006) Radiotherapy in the treatment of mucosal melanoma of the upper aerodigestive tract: analysis of 74 cases. A rare cancer network study. Int J Radiat Oncol Biol Phys 65(3):751–759

    Article  PubMed  Google Scholar 

  19. Wada H, Nemoto K, Ogawa Y, Hareyama M, Yoshida H, Takamura A, Ohmori K, Hamamoto Y, Sugita T, Saitoh M, Yamada S (2004) A multi-institutional retrospective analysis of external radiotherapy for mucosal melanoma of the head and neck in northern Japan. Int J Radiat Oncol Biol Phys 59(2):495–500

    Article  PubMed  Google Scholar 

  20. Owens JM, Roberts DB, Myers JN (2003) The Role of postoperative adjuvant radiation therapy in the treatment of mucosal melanomas of the head and neck region. Arch Otolaryngol Head Neck Surg 129(8):864–868

    Article  PubMed  Google Scholar 

  21. Bartell HL, Bedikian AY, Papadopoulos NE, Dett TK, Ballo MT, Myers JN, Hwu P, Kim KB (2008) Biochemotherapy in patients with advanced head and neck mucosal melanoma. Head Neck 30(12):1592–1598

    Article  PubMed  Google Scholar 

  22. Bachar G, Loh KS, O’Sullivan B, Goldstein D, Wood S, Brown D, Irish J (2008) Mucosal melanomas of the head and neck: experience of the princess margaret hospital. Head Neck 30(10):1325–1331

    Article  PubMed  Google Scholar 

  23. Krengli M, Masini L, Kaanders JH, Maingon P, Oei SB, Zouhair A, Ozyar E, Roelandts M, Amichetti M, Bosset M, Mirimanoff RO (2006) Radiotherapy in the treatment of mucosal melanoma of the upper aerodigestive tract: analysis of 74 cases. A rare cancer network study. Int J Radiat Oncol Biol Phys 65(3):751–759

    Article  PubMed  Google Scholar 

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Correspondence to Manoj Pandey.

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Kumar, V., Shukla, M., Goud, U. et al. Spindle Cell Amelanotic Lesion of the Tongue: a Diagnostic and Therapeutic Challenge. Indian J Surg 75 (Suppl 1), 394–397 (2013). https://doi.org/10.1007/s12262-012-0575-8

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  • DOI: https://doi.org/10.1007/s12262-012-0575-8

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