Longitudinal clinico-pathological data of the progression of oral mucosal melanoma–report of two cases and literature review

Oral mucosal melanoma (OMM) is notorious for having a poor prognosis. Recognition of the early features of OMM by both clinicians and pathologists can play an important role in improving survival. Therefore, the purpose of this report is to increase awareness of the early features of OMM, by presenting two cases with longitudinal clinical and histopathological documentation showing progression of OMM from a deceptively bland pre-malignant (non-invasive) oral melanocytic lesion (POML). Analyzing the clinical and histopathological features of POML in our cases, and those in the literature, we found that the concerning features are: 1) clinically, a pigmented lesion violating the ABCDE criteria or showing multiple recurrences; and 2) histologically, a melanocytic proliferation, in either a lentiginous or pagetoid pattern with or without cellular atypia.

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