{
  "abstract": "This case involves a middle childhood female patient who came with her parents to the Department of Pediatric and Preventive Dentistry with a chief complaint of blackish pigmentation and gum overgrowth in the upper right back tooth region of the jaw for the past month. Clinical examination revealed that the gingival overgrowth was slow-growing and painless. On inspection, the swelling was hard in consistency and non-tender. There was no history of trauma, bleeding while brushing and the lesion was asymptomatic and present on attached gingiva. Histopathological investigation confirmed the diagnosis of primary oral melanoma. The incidence of oral melanoma in children and adolescents under 15 years of age is approximately one per million, with only 1.2% of cases occurring in individuals younger than 15 years of age. 1 Head and neck mucosal melanoma (MM) represents <1% of all melanomas and constitutes approximately 0.26% of all oral malignancies.2 On clinical examination, a dark bluish-black pigmentation with multiple indentations was observed on the maxillary right buccal mucosa, extending from the right maxillary primary lateral incisor to the first primary molar. The lesion also covered the soft palate from teeth number 52 to 54. The lesion measured approximately 3.5×2.1 cm (figure 1). The differential diagnosis for this case includes intradermal dysplastic nevus, benign melanocytic lesion and squamous cell carcinoma, which differentiates in irregular border of lesion, indistinct edges and colour variations.3 Oral melanoma is an extremely uncommon tumour that originates from the uncontrolled growth of melanocyte cells, which are found in the basal layer of the oral mucosa.4 This tumour is influenced by melanocyte-stimulating hormone (MSH). MSH binds to specific receptors on melanocytes, stimulating them to produce melanin.5 6 In oral melanoma, this hormonal regulation may become disrupted, leading to the uncontrolled proliferation of these pigment-producing cells.7 In the histopathological findings (figure 2), localised tumour confined to mucosal epithelium is shown, with nests of atypical melanocytes and connective tissue containing pigmented cells with prominent nuclei. The lesion would show irregular borders with nests of atypical melanocytes extending from the basal layer of the epithelium into the underlying connective tissue. As typically H&E staining and potentially immunostaining with markers like Melan-A or S-100 to confirm the melanocytic origin.6 The crucial feature for Stage I would be the limited invasion depth of the tumour cells, confined to the superficial layers of the lamina propria, not extending deep into the underlying tissue.",
  "authors": [
    {
      "affiliations": [
        "Department of Pediatric and Preventive Dentistry, Sharad Pawar Dental College And Hospital, Datta Meghe Institute of Higher Education and Research (Deemed to be University), Wardha, Maharashtra, India"
      ],
      "name": "Ishani Rahate"
    },
    {
      "affiliations": [
        "Department of Pediatric and Preventive Dentistry, Sharad Pawar Dental College And Hospital, Datta Meghe Institute of Higher Education and Research (Deemed to be University), Wardha, Maharashtra, India"
      ],
      "name": "Punit R Fulzele"
    },
    {
      "affiliations": [
        "Department of Pediatric and Preventive Dentistry, Sharad Pawar Dental College And Hospital, Datta Meghe Institute of Higher Education and Research (Deemed to be University), Wardha, Maharashtra, India"
      ],
      "name": "Dhruvi R Solanki"
    },
    {
      "affiliations": [
        "Department of Pediatric and Preventive Dentistry, Sharad Pawar Dental College And Hospital, Datta Meghe Institute of Higher Education and Research (Deemed to be University), Wardha, Maharashtra, India"
      ],
      "name": "Nilima Thosar"
    }
  ],
  "title": "Clinical image of rare primary oral melanoma in a paediatric patient",
  "uid": "af461921-5624-5da1-a99b-7bbef203c0bd"
}