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A case of amelanotic malignant melanoma occurring in the upper alveolus of a 58-year-old female is presented. The patients was first seen on September 22, 1983, with the chief complaint of the hemorrhagic lesion in the palatal side of the upper right molar. On oral examination, an ulcerous and nodular mass was found in the palatal and buccal sides of the molar. Initially, the tumor was diagnosed as anaplastic cancer from histopathologic findings of the biopsy material taken from the gingiva. Thus, radiation therapy with a total of 3400 rad of 60Co was carried out, resulting in no tumor regression. The 67Ga scintigraphy demonstrated hot uptake of radioisotope in the primary lesion and right side of neck. Partial resection of the maxilla and radical neck dissection were performed under general anesthesia on November 11, 1983. The operation materials revealed the amelanotic malignant melanoma of the primary lesion and its lymph metastasis with a few melanin pigments in the tumor cells. Moreover, the diagnosis was confirmed by ultrastructural findings of the primary tumor. Therefore, the patient was received the following combination chemotherapy as adjuvant therapy: The first regimen included 1 mg of Vincristine, 100 mg of ACNU and a total of 25 mg of Pepleomycin. On the secondary regimen, we exchanged Pepleomycin for DTIC. The combination of ACNU and DTIC appeared to cause delayed myelosuppression with moderate leukopenia and thrombocytopenia. Reversible hepatotoxicity by DTIC was seen 4 weeks after chemotherapy. The patient was observed periodically and no evidence of recurrent or metastatic lesion was found one year after the operation.
社団法人日本口腔外科学会の論文

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