Service de chirurgie maxillofaciale, university hospital Estaing, CHU Clermont-Ferrand, 1, place Lucie Aubrac, 63003 Clermont-Ferrand cedex 1, France; UMR Inserm U1107, Neuro-Dol, Trigeminal Pain and Migraine, faculté de chirurgie dentaire, université d'Auvergne, 2, rue de Braga, 63100 Clermont-Ferrand, France. Electronic address: [Email]
Mucosal melanoma is a rare malignant disease developed from melanocyte. We report the case of a patient with nasal cavity mucosal melanoma with a primary clinical and histological diagnosis of malignant lentigo with mucosal spreading. The presence of a c-Kit mutation, in a second lecture and the evolving nature of the lesion, reorientated the diagnosis of malignant lentigo to mucosal melanoma with skin extension. Extensive surgical resection and foramen free flap with costal graft reconstruction may have a local control of the disease. Yet, after one year, a regional evolution involving a parapharyngeal node was treated by stereotaxic radiotherapy. After 5 years, the patient was considered in clinical and radiological remission. Malignant lentigo with mucosal extension is a very rare situation, this diagnoses must be evoqued after setting mucosal melanoma diagnosis.