Abstract
Oral malignant melanoma (OMM) is a rare neoplasm of the oral cavity that originated from melanocytes. OMM has a low prevalence, accounting for about 0.5% of all oral malignancies. OMM is a potentially aggressive tumour and with a worse prognosis than the cutaneous counterpart. Case Report: A 36-year-old female was referred for a nodular lesion in the left cheek region noticed about 1,5 years prior to presentation. An extraoral examination revealed a palpable lymph node in the left submandible for 3 months. Intraoral examination revealed a black, 5x3×3 cm nodule exhibiting purple-coloured bleeding areas, pedunculated and with well-defined borders and a lobulated surface in the left hard palate extended to maxillary gingiva. The differential diagnosis included rhabdomyosarcoma and melanoma. Incisional biopsy of left submandibular lymph node and fine-needle aspiration biopsy revealed proliferation, hyperchromatic nuclei and melanin contained cytoplasm. Histopathological assessment was metastatic malignant melanoma to the left submandible lymph node. With a final diagnosis of malignant melanoma. Conclusion: OMM is an aggressive disease, with a 5-year survival rate, between 15% and 38%. However, most physicians or dentists do not inspect the oral mucosa appropriately. The main treatment of OMM is surgery followed by chemotherapy and radiotherapy. Early diagnosis and aggressive multimodal treatment are the only means available to surgeons to provide a better outcome to patients with OMM.

Key words: Oral malignant melanoma, pigmented lesions, hard palate