PMC4792064_01
(a) Blackish brown proliferative growth on edentulous maxillary arch and palate and (b) small blackish macules on the soft palate. Contrast enhanced computed tomography showing (c) a large infiltrating homogenous mass on right anterior alveolus. (d) heterogenous enlarged submandibular lymph nodes
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F1
A proliferative fungating growth was seen on the right side of the edentulous maxillary arch and palate, extending over the right alveolar ridge and facial vestibule up to the midline anteriorly, and covering the hard and soft palate up to the tuberosity posteriorly [Figure 1a]. Soft palate showed the presence of 4-5 brownish macules, each 0.5 cm in diameter [Figure 1b]. The contrast enhanced computed tomography (CT) maxilla showed large homogenous mass with infiltrating margins in the right anterior alveolus extending into the hard palate posteriorly [Figure 1c] and skin of the upper lip anteriorly with enlarged right submandibular lymph node [Figure 1d].
Microphotograph showing Case number 1 (a) pleomorphic melanocytes (H and E, x100) and (b) intertwining and fasciculated bundles of malignant melanocytes of (H and E, x400). Case number 2 (c) showing pleomorphic dysplastic melanocytic cells arranged in a pagetoid pattern (H and E, x100) and (d) epithelioid cells interspersed with the pigmented cells (H and E, x400). Case number 3 showing (e and f) atypical melanocytes singly and in nests in pagetoid fashion and in sheets (e: H and E, x40; f: H and E, x100)
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F2
Histopathological examination showed infiltration of atypical melanocytes singly and in nests, in a pagetoid and organoid fashion [Figure 2e and f] showing granular pigmentation and hyperchromatism.
PMC4792064_02
Microphotograph showing Case number 1 (a) pleomorphic melanocytes (H and E, x100) and (b) intertwining and fasciculated bundles of malignant melanocytes of (H and E, x400). Case number 2 (c) showing pleomorphic dysplastic melanocytic cells arranged in a pagetoid pattern (H and E, x100) and (d) epithelioid cells interspersed with the pigmented cells (H and E, x400). Case number 3 showing (e and f) atypical melanocytes singly and in nests in pagetoid fashion and in sheets (e: H and E, x40; f: H and E, x100)
CCD-7-87-g002.jpg
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F2
Histopathological examination showed infiltration of atypical melanocytes singly and in nests, in a pagetoid and organoid fashion [Figure 2e and f] showing granular pigmentation and hyperchromatism.
(a and b) Brownish black, irregular growth extending from 13 to 27 on both buccal and lingual aspects involving ridge area. Contrast enhanced computed tomography showing (c) a homogeneous mass with the erosion of left alveolar arch and (d) extension into the left lateral margin of hard palate
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F3
Intraorally, brownish black, irregular growth of 6 cm x 4 cm was seen extending from 13 to 27 on both buccal and lingual aspects involving ridge area [Figure 3a and b]. Radiographically, a homogeneously enhancing soft tissue mass was seen involving left gingivoalveolar complex with the erosion of left alveolar arch [Figure 3c], extension into the left lateral margin of hard palate [Figure 3d] with the destruction of inferolateral wall of left maxillary sinus.
PMC4792064_03
Microphotograph showing Case number 1 (a) pleomorphic melanocytes (H and E, x100) and (b) intertwining and fasciculated bundles of malignant melanocytes of (H and E, x400). Case number 2 (c) showing pleomorphic dysplastic melanocytic cells arranged in a pagetoid pattern (H and E, x100) and (d) epithelioid cells interspersed with the pigmented cells (H and E, x400). Case number 3 showing (e and f) atypical melanocytes singly and in nests in pagetoid fashion and in sheets (e: H and E, x40; f: H and E, x100)
CCD-7-87-g002.jpg
PMC4792064_03_CCD-7-87-g002.jpg
F2
Histopathological examination showed infiltration of atypical melanocytes singly and in nests, in a pagetoid and organoid fashion [Figure 2e and f] showing granular pigmentation and hyperchromatism.
(a) Well circumscribed ovoid growth on maxillary anterior region. (b) Contrast enhanced computed tomography showing heterogenous soft tissue mass perforating the anterior hard palate. (c and d) 18F-fluorodeoxyglucose positron emission tomography-computed tomography scan showing metastatic deposits in lymph nodes (cervical, supraclavicular, mediastinal, and abdominal), liver, lung, and brain. Inset shows multiple deposits in the brain
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F4
The growth was well circumscribed ovoid, soft, and nontender [Figure 4a]. CT scan showed heterogenous soft tissue mass perforating the anterior hard palate [Figure 4b]. The whole-body 18F-fluorodeoxyglucose positron emission tomography-computed tomography scan showed metastatic deposits in lymph node (cervical, supraclavicular, mediastinal, and abdominal), liver, lung, and brain [Figure 4c and d].