A neoplasm of epidermal melanocytes and third most common cancer of skin.

▪️Arises in preexisting mole. Appearance – Large, flat, spreading lesion; deeply pigmented Nodule

🔹Precursor Lesions:

(i) Congenital Nevi

https://dentowesome.wordpress.com/2020/05/18/oral-nevi/

(ii) Dysplastic Nevi (Atypical Mole)

(iii) Lentigo Maligna: Also called as Hutchinson’s freckle, is a tan or black on the skin that looks like a freckle.

• Grows slowly
• Dark, thick, nodular, mottled
• Seen on one side of the face of an older adult who had a large amount of sun exposure.

🔹Etiology:

• Genes in the development of Melanoma:

• Phases in the growth of Melanoma:

1. Radial
2. Vertical

🔹Classification:

1. Superficial spreading Melanoma:

• most common type (65%)
• Radial growth phase – premalignant melanosis/pagetoid melanoma in situ
• Vertical growth phase – Increase in size, color, nodularity/ulceration
• Lesions are usually flat, scaly or crusty & 2 cm in diameter
• Found in trunk & back of Men; Legs of women
• Median age of occurrence – 50’s

2. Lentigo Maligna Melanoma:

• Least serious form
• More in women
• Macular lesion on malar skin of middle-aged and elderly

3. Nodular Melanoma:

• Exhibits only vertical growth phase
• Sharply delineated nodule, may be pink/black
• Occur in men on skin of head, neck & trunk
• Looks like blood blister

4. Acral Lentiginous:

• Also called muco-cutaneous Melanoma
• Less common with fair skin
• Palms of hands, soles of feet, mucous membrane, nail beds
• Median age of occurrence – in 50’s & 60’s

Assessing the ABCDE’s of Moles

🔹Oral Manifestations:

• Age: 55 yrs
• Sex: M>F
• Site: Palate/Gingiva
• Appearance: Deeply pigmented area; ulcerated/haemorrhagic; ⬆️ size
• Amelanotic melanomas: 5-35% of oral cases

Melanoma stages 5 years survival rates:

• Stage 0: Melanoma in situ ( Clark level I), 99.9% survival
• Stage I/II: Invasive melanoma, 85-99% survival
• Stage II: High risk Melanoma, 40-85% survival
• Stage III: Regional Metastasis, 25-60% survival
• Stage IV: Distant Metastasis, 9-15% survival

🔹Treatment depends on stage:

➡️ Metastases that cause symptoms but cannot be removed may be treated with radiation, immunotherapy, targeted therapy, or chemotherapy.

Dr. Mehnaz Memon🖊

---

References: Shafer’sTextbook Of Oral Pathology; Textbook Of Surgery by S.Das