PMC10310326_01
(a-d): Magnetic resonance imaging (MRI) image shows the T2W sagittal section of the lesions.
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Superioinferiorly the lesion was extending from the marginal gingiva (in relation to 43, 45, 46 regions) to the floor of the mouth (Figure 1). The overall findings were suggestive of malignant lesions (Figure 1). The patient did not go for a positron emission tomography scan as he was from a low socioeconomic background.
H & E stained sections of oral malignant melanoma. (a): A-4x view of the lesion shows the lesional tissue which is composed of malignant melanocytes infiltrating into the connective tissue stroma. (b): B-10x melanocytes are infiltrating into the connective tissue stroma in the form of sheets, chords. (c): C-40x melanocytes are round in shape, exhibit nuclei of varying sizes which occupies nearly the entire cell cytoplasm.
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The connective tissue stroma showed dysplastic characteristics indicative of malignant melanoma, such as cellular atypia and anisocytosis (Figure 2a-c).
IHC analysis reveals lesional tissue is positive for (a): HMB-45, (b): Melan-A and (c): S-100 markers, respectively.
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Thus, antibodies to S-100, homatropine methylbromide 45 (human melanoma black (HMB45)), and melan A showed strong positive for tumour cells (Figure 3a-c).
(a): Post-operative image of the second follow-up (after the incisional biopsy) represents that the lesion was aggravated and completely obliterating the pharyngeal spaces. (b-d): Operative images. (e): Extraoral postoperative.
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Immediate surgery was planned as it had obscured the oropharyngeal spaces (Figure 4). Unfortunately, the patient passed away 2 months after surgery (Figure 4).