65 male, oral biopsy- right buccal alveolus, hpe images



Thanks for this case. It seems the photographs are out of focus at places. However, this microphotos depict deposits of a malignant tumour. There are foci of well defined glandular differentiation, poor differentiation and pigmentation. Chance of melanoma is less likely as there are adenomatous pattern. The weight of evidence inclined me more towards a metastatic dedifferentiated epithelial tumour. Primary could be in the nasopharyngeal region. Thank you all.

?Malignant melanoma

Looks like malignant melanoma. Do the HMB 45 and S 100 markers to confirm.

Tumour cells are arranged in adenoid fashion, in Indian file, trabecular, solid sheets etc. tumour cells are medium size, inconspicuous nucleoli, mild cytological atypia. Polymorphic low grade adeno carcinoma, minor salivary gland, oral cavity.

poorly differentiated adenocarcinoma

Most likely to be Malignant melanoma. Advice S100, HMB45

adenomatoid odontogenic tumour

Malignant melanoma may be in nasopharyngeal region

carcinoma ex pleomorphic adenoma

Malignant melanoma. Advised s100, melanoma A, HMB45.

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