Intramucosal melanotic nevi – A case report of an unusual gingival enlargement
A 26-year-old male presented at the outpatient department with the chief complaint of irritation from lower anterior teeth and a mass present on upper front region of jaw []. Tumor was present since birth, was red in color initially and it gradually increased to its present size.\nPatient sustained an accident one year back, which caused loss of right, lateral incisor and following accident the color of the mass changed to black. Lesion was asymptomatic otherwise.\nClinical examination revealed an indurate, black nodular lesion of about 8-10 cm in diameter, firm in consistency and rough textured with irregular margins.\nPeriodontal probe was used to detect any false or true pocket but there was no evidence of periodontal disease. Radiographically, neither the bone loss nor any sign of radiolucency was present. Preoperative clinical diagnosis was fibrous enlargement vis-à-vis to melanoma. Patient was advised extraction of right central incisor [Figures and ] (In consultation with department of prosthodontic to rule out its interference with fixed prosthesis fabrication.)\nIncision biopsy was performed. Following histological report of nevus, gingivectomy was undertaken with adequate alveoloplasty [Figures and ]. Healing was satisfactory after one month [].\nH and E section revealed parakeratinized stratified squamous epithelium. Pigmented nevus cells were seen in circumscribed groups (theques) in the connective tissue subjacent to the epithelium. Chronic inflammatory cells were also present around the theques. A diagnosis of Intramucosal Melanotic Nevi was offered [Figures and ].\nThe patient remained uneventful almost one year following operation till date and is advised follow up.