Malignant melanoma oral cavity: case report of two patients from sub-Himalayan region

Abstract

Malignant melanoma of the oral cavity is an exceedingly rare tumor representing 0.2 to 8% of all melanomas. Mucosal melanomas are extremely rare and aggressive neoplasms. Patient reporting to the clinician with a pigmented lesion should raise suspicion in the first visit itself and should be further investigated so as to detect this dreaded malignancy at an earlier stage and thus managed appropriately. We present two such rare cases who reported at our centre treated with different treatment modalities and had different responses to treatment. In first case report 65 year old male patient diagnosed with malignant melanoma of left upper alveolus underwent multiple modalities of treatment like surgery, chemotherapy, radiation therapy but unfortunately as he defaulted post-surgery and also due to COVID-19 lockdown restrictions he was treated in various centres and finally the result was inoperable residual gigantic mass resistant to chemotherapy and radiation therapy. In second case report, 82 year old male patient reported with malignant melanoma hard palate having good response to initial chemotherapy. He was planned on hypo-fractionated radiotherapy in view of his old age but he refused radiation treatment and is on oral temozolamide and thalidomide with stable disease and good quality of life since past 6 months.