Oral multiple deep penetrating nevi (DPN) extending to the masseter and buccal fat pad

Publication date: Available online 1 June 2017
Source:Journal of Oral and Maxillofacial Surgery
Author(s): Eunae S. Cho, Hye-Min Cho, Woong Nam, Hyun Sil Kim
Deep penetrating nevus (DPN) is a rare benign melanocytic tumor, clinically and histopathologically mistaken frequently as malignant melanoma (MM) and other types of nevi. Here we report an extremely rare case of multiple lesions of large DPN at the oral cavity with extensive infiltration to the minor salivary gland, buccal fat pad, buccinators and masseter muscles, yet with preservation of normal anatomic architecture. Being diagnosed as MM in another hospital, the patient was at risk for receiving wide excision including the masticatory muscles, facial nerve and overlying skin. Histopathologically, distinct cellular properties were completely masked with heavy pigmentation precluding proper distinction of benign/malignancy. We further analyzed the proliferative capacity of the tumor by immunohistochemistry in bleached tissue sections and indirectly evaluated the tumor behavior with insufficient tumor stromal interaction, concluding the specimen to be benign. Conservative surgery was done limited to the oral cavity. Multiple DPN in oral cavity merits attention due to the high risk of being mistaken as MM requiring wider surgical excision of the head and neck region.



http://ift.tt/2rrVKg3