Recurrent Malignant Melanoma on the Tongue: A Case Report and Review of the Literature

TL;DR

A 33-year-old woman with a history of tongue melanoma had a recurrence, which was successfully treated with surgery and radiotherapy, highlighting the importance of early detection and comprehensive care.

Contribution

This case report adds to the limited literature on recurrent malignant melanoma of the tongue and emphasizes the importance of thorough clinical and histopathological evaluation.

Findings

Recurrent malignant melanoma on the tongue was successfully resected with clear surgical margins.

The patient remained recurrence-free for 3 years following treatment with surgery and adjuvant radiotherapy.

Early detection and multidisciplinary treatment are crucial for improving outcomes in rare oral melanomas.

Abstract

Melanoma of the oral mucosa is an uncommon cancer arising from the tissues lining the mouth. Among oronasal malignant melanomas, tongue melanoma makes up a mere 2%. Optimal treatments for this rare and often late‐stage disease remain elusive. However, surgery with free margins is considered the primary treatment and is often combined with other therapies such as neck dissection, adjuvant radiotherapy, chemotherapy, and immunotherapy.

This case involves a 33‐year‐old woman with a history of malignant melanoma on her tongue. She had previously undergone a partial glossectomy and was on maintenance imatinib treatment for ~2 years. During her follow‐up, a new lesion was discovered on her tongue, which was confirmed to be malignant melanoma and was resected. The tumor exhibited a depth of invasion of 8 mm. All surgical margins were clear, with the closest margin being 3 mm. The lesion was reconstructed with a submental flap. Adjuvant radiotherapy was also given. The patient has been on maintenance follow‐up for 3 years with no signs of recurrence.

Malignant melanoma should be considered in the differential diagnosis of pigmented and non‐pigmented lesions of the tongue and oral mucosa. A thorough clinical evaluation, followed by histopathological and immunohistochemical examination of any suspicious lesions, is essential for early diagnosis. Early detection and prompt treatment are crucial for optimizing patient outcomes and improving survival rates.

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