Intraoral desmoplastic melanoma requiring radical multidisciplinary resection and free flap reconstruction: case report and literature review.

Authors

Frank A Álvarez Vásquez, Juan P Zaraza Duarte, Laura A Garzón Bautista, Iván E Rodríguez Mantilla, Nicol D Cala Gómez, Daniela Marulanda Grajales, Nidya C Guataquira Sierra

Published in

Journal of surgical case reports. Volume 2026. Issue 9. Pages rjag498. Epub Sep 01, 2026.

Abstract

Desmoplastic melanoma (DM) is a rare variant of malignant melanoma characterized by spindle cell proliferation within dense collagenous stroma and atypical immunohistochemical profile. Intraoral involvement is exceedingly uncommon and poses diagnostic and therapeutic challenges. We report the case of a male patient in his fourth decade presenting with enlarging right orofacial mass associated with extensive soft tissue and osseous infiltration. Histopathological evaluation revealed infiltrative spindle cell neoplasm with focal melanin pigment and limited expression of conventional melanocytic markers, requiring integrated diagnostic approach. The patient underwent radical en bloc resection followed by immediate reconstruction using anterolateral thigh free flap. Adjuvant systemic therapy was not administered; however, it was evaluated within multidisciplinary tumor board. At 12-month follow-up, no locoregional recurrence was observed. This case underscores diagnostic complexity of intraoral DM and highlights importance of multidisciplinary oncologic approach in optimizing management outcome.

PMID:
42683475
Bibliographic data and abstract were imported from PubMed on 02 Sep 2026.

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