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Open Access Case Report

Immunohistochemical features of multifocal melanoacanthoma in the hard palate: a case report

Luis Felipe das Chagas e Silva de Carvalho12, Vitor Hugo Farina1, Luiz Antonio Guimarães Cabral1, Adriana Aigotti Haberbeck Brandão1, Ricardo Della Coletta3 and Janete Dias Almeida14*

Author Affiliations

1 Department of Biosciences and Oral Diagnosis, São José dos Campos Dental School, São Paulo State University (UNESP), São José dos Campos, São Paulo, Brazil

2 Nanosciences and Advanced Materials, Federal University of ABC, Santo André, São Paulo, Brazil

3 Department of Oral Diagnosis, Oral Pathology Division, Piracicaba Dental School, University of Campinas, Piracicaba, São Paulo, Brazil

4 Faculdade de Odontologia de São José dos Campos – UNESP, Departamento de Biociências e Diagnóstico Bucal, Av. Francisco José Longo, 777 São Dimas, 12245-000, São José dos Campos, São Paulo, Brazil

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BMC Research Notes 2013, 6:30  doi:10.1186/1756-0500-6-30

Published: 28 January 2013

Abstract

Background

Melanoacanthoma (MA) has been described in the oral mucosa as a solitary lesion or, occasionally, as multiple lesions. MA mainly affects dark skinned patients and grows rapidly, showing a plane or slightly raised appearance and a brown to black color. The differential diagnosis includes oral nevi, amalgam tattoos, and melanomas. We report here the case of a 58-year-old black woman who presented multiple pigmented lesions on the hard palate.

Case presentation

Based on the differential diagnosis of melanoma, a punch biopsy (4 mm in diameter) was performed. The material was fixed in 10% formalin, embedded in paraffin, and stained with hematoxylin-eosin or submitted to immunohistochemical analysis. Immunohistochemistry using antibodies against protein S-100, melan-A, HMB-45, MCM-2, MCM-5, Ki-67 and geminin was performed. Immunohistochemical analysis revealed strong cytoplasmic immunoreactivity of dendritic melanocytes for proteinS-100, HMB-45 and melan-A.Positive staining for proliferative markers (MCM-2, MCM-5, Ki-67) was only observed in basal and suprabasal epithelial cells, confirming the reactive etiology of the lesion. The diagnosis was oral Melanoacanthoma (MA).

Conclusion

The patient has been followed up for 30 months and shows no clinical alterations. MA should be included in the differential diagnosis of pigmented lesions of the oral cavity.

Keywords:
Melanoacanthoma; Mouth; Pigmented lesions