Amelanotic melanoma of the palate: report of case.

Malignant melanoma mainly arises in the skin. It represents the leading cause of death from cutaneous malignancy in the United States today.1,2 Fewer than 1% of all reported primary melanomas arise in the oral cavity.3,4 The cutaneous form of this lesion normally is highly visible, with irregular borders and dark pigmentation. However, mucosal melanomas may present a diagnostic challenge for the clinician. Rarely, melanoma may present itself without clinically evident pigmentation. Termed amelanotic melanoma, these lesions tend to have a worse prognosis because of delayed recognition and subsequent treatment.5 However, the prognosis may improve with early detection and wide local excision.6,7 Metastases from amelanotic melanomas have similar characteristics to their primary counterparts; they also lack pigmentation and grow rapidly. In a study of amelanotic melanoma by Huvos et al,5 the primary site was never identified in 29% of the patients. To our knowledge, amelantotic melanoma of the oral cavity has not been reported previously.