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Correspondence |

Metastatic Melanoma of the Tongue Arising From Oral Melanosis

Katharina C. Kaehler, MD; Paul A. J. Russo, MD; Friederike Egberts, MD; Patrick H. Warnke, MD, DMD; Lorenzo Cerroni, MD; Axel Hauschild, MD
Arch Dermatol. 2008;144(4):558-560. doi:10.1001/archderm.144.4.558-b.
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Primary oral melanoma is a rare tumor that has been estimated to represent 0.1% of melanoma cases in whites.1 A review of 20 cases of tongue melanomas1 and a literature survey in PubMed revealed a total of 32 published cases. One-third of patients diagnosed as having primary oral melanoma also had preexisting pigmented lesions at the same site. The prognosis is poor, with a 5-year survival rate of only 26.4%.2 We report a lethal case of primary melanoma of the tongue that developed within an oral melanosis that had been biopsied 9 years before its malignant transformation.

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Figure 1.

Findings in 1993. A, Clinical appearance of a melanotic lesion at the right lateral edge of the tongue. B, Histologic appearance of benign oral pigmentation. There is pronounced basal hyperpigmentation without elongation of rete ridges (hematoxylin-eosin, original magnification ×50).

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Figure 2.

Findings in 2002. A, Malignant melanoma, right side of the tongue, after excisional biopsy. B, Invasive spindle cell desmoplastic melanoma (hematoxylin-eosin, original magnification ×50).

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