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Blue nevus of oral mucous membrane
Blue nevus of oral mucous membrane Report
of a case
Leo 31. Mack, C’nptain, I:RAF,* and If. W. Woodauard, C’olonel, USAF”” ANDREWH
AIR
FORCE
BASE,
WASHINGTOS,
D.
C.
O.S., O.M. & O.P. June, 1968
Table
I AW 24
scz
IlaW
M
w
Size f mm. i
Elrvated
Hard palate
2 by 2
Yes
Clinical impression -
Location
Scofield’
41
W
Posterior hard palate
2 by 4
Yes
Blue nevus
Harper and Waldrona
69
W
Soft
3 by 3
Yes
Nrvus
&Sprague and Dirlams
18
W
Anterior hard
3 by 5
Yes
Hhaskar and Jacomay4
25
F
46 17
M F
W
Mark and Kaplan5
34
F
Mack and Woodward
32
M
Pig.
I. Blue
undermined, was sent
for
Pathology
report
nevus
M
palate
-
palate -
Posterior hard palate Hard palate Upper lip mucou5 membrane
5by4
W
Posterior hard palate
2 by2
Yes
Melanoma
W
Hard
3by2
Yf?S
Blue nevus
palate
-
4 by 4
-
of palate.
and the elliptical wound microscopic examination,
was closed with one suture The wound healed without
of 4-O silk. The eomplicati,on.
specimen
The specimen consisted of an elliptical segment of mucosa which measured 10 by 7 mm. The external surface showed a 2 by 3 mm. pigmented area. Microscopically, the lesion was composed ,of numerous spindle-shaped cells with long cytoplasmic processes. The cells contained brown pigment. Appropriate laboratory procedures conclusively established the presence of melanin in the lesion. The covering epithelium was essentially normal stratified squamous epithelium. pnt1,n1nm;r.
i7;nrrno*;c
PI..”
_ ,,_-..__,_
Volume Number
25 6
Pig. pigmented nification,
2. Photomicrograph of nevus cells concentrated x50.)
Blue
vbews
of oral mucous
section through blue nevus. Note in deep dermal zone. (Hematoxylin
Pi,g. 3. Photomicrograph of nevus cells from blue nevus IWVUY cell is spindle shaped, with an ovoid nucleus, and granules. CHematoxylin and tqsin stain. Magnification, x280.)
of hard heavily
irregular and
membrane
arrangement eosin stain.
931
of Mag-
palate. The typical blue pigmented wvlth melanin
COMMENT piglwlltatiolt is tmt. a11unc011mui1 finding, although clinica;ll tlift’t>rp11of such lesions is not, reliable. In a review of 105 cases of oral melanoma, C%audhry and associafes7found that 80 per rent of the lesions arose on the mucous membrane of the maxilla, wit,h 51 per cent located on the hard palate. In t,he same study it was also noted that 30 per cent of the melanomas lesions which had ken present frown a reviewed were preceded by gign~entc~ti few months to several years. WiyTitht,his in mind, it is our opinion that pigmelltcd lesions of unknown origin in the oral cavity should be adequately excised and subjected to propel histologic examination. ()r’a/
tiation
O.R., O.M. & O.P. June, 1968
SUMMARY
1 CRSCinvolving a rare oral l&on, the blue nexus, has been presented. OnI>~~igi~tprevious blue nevi have been reported in the literature (Table I). Since clinical evaluation of pigmented lesions is of questionable value, total c>scisionof oral pigmented lesions is advised. ADDENDUM
,Since this article was submitted for publication, intraoral blue nexus have been reported.fi
two additional
cases of
REFERENCES
H. H.: The Blue (Jadassohn-Tieche) News: A Previously t:nreported Intraoral T,esion. Oral Sure.. Anesth. & How. D. Serv. 17: 4-14. 1959. Harper, .J. ‘C., and @Lldron, C. A.: Blue News of the &ate, ORAL SGRCL, ORAL MED. & ORAL PATH. 20: 145-149, 1965. Sprague, W. G., and J)irlam. J. H.: Intraoral Blue News: Heport of a Case, J. Oral Sirff-1 Ailesth. & Hosp. D. Serb. 21: 162-164, 1963. Hhaskar. S. N.. and Jacowav. 5. R,.: Blue Nevus of the Oral Mucosa (Oral Surzerv Conferehce No.’ 12, Walter Gded Arm?; Medical Center), ORAL SURG., ORAL‘ MEI). & GRAY, PATH. 19: 678-683, 1965. Mark, H. I., aud KnDlan. S. I.: Blue News of the Oral Cavitv. ORAL SURG., ORAL MEIL & ORAL PAT&. 24: 15i-156. 1967. Bernier, ,T. L., and Tiecke, R. W.: Kevus of the Gingiva, .J. Oral Surg. 8: 165-167, 1950. ChaudhrJ-, 8. P., and others: Primary Malignant Melanoma of the Oral (:avity: A Review of io.5 Cases, Cancer 11: 92%928,“1958. ‘~ McCYra, M. W., and Miller, A. R.: Intraoral Blue Pievi, ORAI, STXG., ORAL MED. & ORAL PATJT. 25: 590-593, 1968.
1. Hcofield,
z?. :3.
4. 5. 6. 7. 8.
of a case
Leo 31. Mack, C’nptain, I:RAF,* and If. W. Woodauard, C’olonel, USAF”” ANDREWH
AIR
FORCE
BASE,
WASHINGTOS,
D.
C.
O.S., O.M. & O.P. June, 1968
Table
I AW 24
scz
IlaW
M
w
Size f mm. i
Elrvated
Hard palate
2 by 2
Yes
Clinical impression -
Location
Scofield’
41
W
Posterior hard palate
2 by 4
Yes
Blue nevus
Harper and Waldrona
69
W
Soft
3 by 3
Yes
Nrvus
&Sprague and Dirlams
18
W
Anterior hard
3 by 5
Yes
Hhaskar and Jacomay4
25
F
46 17
M F
W
Mark and Kaplan5
34
F
Mack and Woodward
32
M
Pig.
I. Blue
undermined, was sent
for
Pathology
report
nevus
M
palate
-
palate -
Posterior hard palate Hard palate Upper lip mucou5 membrane
5by4
W
Posterior hard palate
2 by2
Yes
Melanoma
W
Hard
3by2
Yf?S
Blue nevus
palate
-
4 by 4
-
of palate.
and the elliptical wound microscopic examination,
was closed with one suture The wound healed without
of 4-O silk. The eomplicati,on.
specimen
The specimen consisted of an elliptical segment of mucosa which measured 10 by 7 mm. The external surface showed a 2 by 3 mm. pigmented area. Microscopically, the lesion was composed ,of numerous spindle-shaped cells with long cytoplasmic processes. The cells contained brown pigment. Appropriate laboratory procedures conclusively established the presence of melanin in the lesion. The covering epithelium was essentially normal stratified squamous epithelium. pnt1,n1nm;r.
i7;nrrno*;c
PI..”
_ ,,_-..__,_
Volume Number
25 6
Pig. pigmented nification,
2. Photomicrograph of nevus cells concentrated x50.)
Blue
vbews
of oral mucous
section through blue nevus. Note in deep dermal zone. (Hematoxylin
Pi,g. 3. Photomicrograph of nevus cells from blue nevus IWVUY cell is spindle shaped, with an ovoid nucleus, and granules. CHematoxylin and tqsin stain. Magnification, x280.)
of hard heavily
irregular and
membrane
arrangement eosin stain.
931
of Mag-
palate. The typical blue pigmented wvlth melanin
COMMENT piglwlltatiolt is tmt. a11unc011mui1 finding, although clinica;ll tlift’t>rp11of such lesions is not, reliable. In a review of 105 cases of oral melanoma, C%audhry and associafes7found that 80 per rent of the lesions arose on the mucous membrane of the maxilla, wit,h 51 per cent located on the hard palate. In t,he same study it was also noted that 30 per cent of the melanomas lesions which had ken present frown a reviewed were preceded by gign~entc~ti few months to several years. WiyTitht,his in mind, it is our opinion that pigmelltcd lesions of unknown origin in the oral cavity should be adequately excised and subjected to propel histologic examination. ()r’a/
tiation
O.R., O.M. & O.P. June, 1968
SUMMARY
1 CRSCinvolving a rare oral l&on, the blue nexus, has been presented. OnI>~~igi~tprevious blue nevi have been reported in the literature (Table I). Since clinical evaluation of pigmented lesions is of questionable value, total c>scisionof oral pigmented lesions is advised. ADDENDUM
,Since this article was submitted for publication, intraoral blue nexus have been reported.fi
two additional
cases of
REFERENCES
H. H.: The Blue (Jadassohn-Tieche) News: A Previously t:nreported Intraoral T,esion. Oral Sure.. Anesth. & How. D. Serv. 17: 4-14. 1959. Harper, .J. ‘C., and @Lldron, C. A.: Blue News of the &ate, ORAL SGRCL, ORAL MED. & ORAL PATH. 20: 145-149, 1965. Sprague, W. G., and J)irlam. J. H.: Intraoral Blue News: Heport of a Case, J. Oral Sirff-1 Ailesth. & Hosp. D. Serb. 21: 162-164, 1963. Hhaskar. S. N.. and Jacowav. 5. R,.: Blue Nevus of the Oral Mucosa (Oral Surzerv Conferehce No.’ 12, Walter Gded Arm?; Medical Center), ORAL SURG., ORAL‘ MEI). & GRAY, PATH. 19: 678-683, 1965. Mark, H. I., aud KnDlan. S. I.: Blue News of the Oral Cavitv. ORAL SURG., ORAL MEIL & ORAL PAT&. 24: 15i-156. 1967. Bernier, ,T. L., and Tiecke, R. W.: Kevus of the Gingiva, .J. Oral Surg. 8: 165-167, 1950. ChaudhrJ-, 8. P., and others: Primary Malignant Melanoma of the Oral (:avity: A Review of io.5 Cases, Cancer 11: 92%928,“1958. ‘~ McCYra, M. W., and Miller, A. R.: Intraoral Blue Pievi, ORAI, STXG., ORAL MED. & ORAL PATJT. 25: 590-593, 1968.
1. Hcofield,
z?. :3.
4. 5. 6. 7. 8.