Desmoplastic melanoma of the oral cavity: diagnostic pitfalls and clinical characteristics

J Korean Assoc Oral Maxillofac Surg. 2018 Apr;44(2):66-72. doi: 10.5125/jkaoms.2018.44.2.66. Epub 2018 Apr 25.

Abstract

Objectives: Desmoplastic melanoma of the oral cavity is an extremely rare condition that is often confused on initial diagnosis with non-melanotic benign lesion or spindle cell tumors. The purpose of this article was to raise awareness of the disease using a literature review.

Materials and methods: We analyzed 19 desmoplastic melanoma cases reported in the literature and added our experience. Data on clinical, histopathology, treatment, and survival were retrieved and analyzed. Survival analysis was by the Kaplan-Meier method.

Results: Initial clinical and histopathological features were indistinctive, and a definite diagnosis of desmoplastic melanoma at initial assessment was possible in only 23.5% of cases. Among tests, immunohistochemical studies for S-100 and vimentin were all positive. The 5-year disease-free survival rate for oral desmoplastic melanoma was 0%, and the 5-year overall survival rate was 55.0%.

Conclusion: Oral desmoplastic melanoma has a high percentage of initial misdiagnosis and propensity for local recurrence. Thus, careful initial diagnosis and adequate surgery may result in improved overall survival.

Keywords: Diagnosis; Oral desmoplastic melanoma; Recurrence; Survival.