Conservative Management of In Situ Melanoma of the Palatal Mucosa: Case Report

Abstract

Oral mucosal melanoma is a rare malignant neoplasm, representing a clinical subtype cha­racterized by aggressive behavior and a poor prognosis. We report the case of a 56-year-old female patient presenting with a hyperpigmented macule on the hard palate, which had recently increased in size following decades of clinical stability. Incisional biopsy confirmed an in situ melanoma of the lentiginous subtype. Positron emission tomography/computed tomography revealed focal tracer uptake in the palatal mucosa with no evidence of distant metastases. A total palatal mucosectomy and sentinel lymph node biopsy were performed, achieving tumor-free surgical margins and no nodal involvement. The postoperative cour­se was favorable, with complete mucosal healing and no signs of recurrence at six-month follow-up. This case illustrates the therapeutic potential of mucosectomy as a conservative and effective strategy for localized melanocytic lesions, allowing preservation of oral func­tion while avoiding more extensive procedures. It also emphasizes the importance of early diagnosis and individualized treatment planning in the management of rare oral cavity neoplasms.