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What is the preferred site for oral melanocytic nevi?
What is necessary to confirm the diagnosis of oral melanocytic nevi?
At what age does the incidence of malignant melanoma peak?
What is a risk factor for cutaneous melanoma?
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What is the typical appearance of early oral melanomas?
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What is the stage of melanoma where the malignant melanocytes grow only within the epithelium?
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What is the most common site for oral malignant melanoma?
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What is the stage of melanoma where the melanocytes extend out of the epithelium into the connective tissue?
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What is the primary pathophysiological mechanism associated with oral melanoacanthoma?
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What is the typical size range of oral melanoacanthoma lesions?
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What is the primary distinguishing feature of oral melanoacanthoma histologically?
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Why is an incisional biopsy necessary for oral melanoacanthoma diagnosis?
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What are melanocytic nevi commonly referred to as?
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What is the primary cause of focal oral pigmentation in melanocytic nevi?
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What is the characteristic appearance of intraoral melanocytic nevi?
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Which of the following factors contributes to the development of melanocytic nevi?
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What is the estimated prevalence of oral/labial melanotic macules in the population?
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In which age group are oral/labial melanotic macules typically observed?
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What is the primary cause of oral/labial melanotic macules?
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Where are oral melanotic macules most commonly observed?
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What is the typical size of oral/labial melanotic macules?
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What is the malignant potential of oral/labial melanotic macules?
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What is the recommended management for suspected oral/labial melanotic macules?
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What is the most common demographic characteristic of oral melanoacanthoma?
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Study Notes
Melanocytic Lesions
- Palate and gingiva are favored sites for oral melanocytic lesions.
- Histologically, a cluster of naevus cells is seen below the epithelium.
Malignant Melanoma
- Malignant melanoma is a neoplasm of melanocytic origin, with most cases occurring on the skin.
- Incidence of malignant melanoma increases with age, reaching a peak between 80 and 84 years.
- Oral malignant melanoma occurs much less frequently than its cutaneous counterpart.
- Ultraviolet light exposure, fair complexion, and sun sensitivity cause cutaneous melanoma, but no aetiological factors are known for mucosal melanoma.
- Malignant melanomas may develop denovo or from a preexisting benign melanocytic lesion.
Clinical-Pathologic Features of Malignant Melanoma
- The most frequent sites are the palate and upper alveolar ridge.
- Early oral melanomas are asymptomatic dark brown or black flat patches.
- Symptoms only develop in the late stages with nodular growth, pain, ulceration, bleeding, or loosening of teeth.
- Melanomas grow in a predictable fashion, initially spreading laterally within the epithelium, and later extending into the connective tissue.
Oral Melanoacanthoma
- Oral melanoacanthoma typically presents as a diffuse, rapidly enlarging area of macular pigmentation.
- Histologically, it is characterized by spongiotic epithelium containing dendritic pigmented melanocytes throughout the lesional epithelium.
- The pathophysiologic mechanism is most consistently associated with acute regional trauma or chronic irritation.
Patient Management
- A biopsy is necessary to confirm the diagnosis of oral melanocytic nevi and to rule out malignant melanoma.
- Treatment of oral melanoacanthoma is typically not indicated after diagnosis has been established.
Melanocytic Nevus
- Melanocytic nevi, commonly referred to as “moles,” represent a group of benign tumors that develop due to melanocytic growth and proliferation.
- In general, melanocytic nevi are acquired lesions with both environmental and genetic factors thought to play a role in their development.
Clinical-Pathologic Features of Melanocytic Nevus
- Intraoral lesions are unusual and form circumscribed brown to black patches, usually flat, approximately 5 or 6 mm across.
- Oral/labial melanotic macules are present in up to 3% of the population, are typically observed in patients in the fourth and fifth decades, and have a 2:1 female predilection.
Oral/Labial Melanotic Macules
- Oral/labial melanotic macules are solitary, well-circumscribed lesions that are typically less than 1 cm in diameter.
- They may appear on any surface but are most commonly observed on the buccal mucosa, gingiva, and palate.
- Histopathological analysis reveals an increase in melanin in the basal and parabasal layers of normal stratified squamous epithelium without an increase in the number of melanocytes.
Patient Management of Oral/Labial Melanotic Macules
- Oral/labial melanotic macules are considered benign lesions without malignant potential.
- Since early malignant melanoma may have a similar clinical appearance, it is strongly advisable to perform an excisional biopsy for any suspected macules.
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Description
This quiz covers the characteristics and management of oral melanocytic nevi and malignant melanoma, including their histology and diagnosis.
