Primary malignant melanoma arising in the parotid gland: Case report and literature review

Melanoma of the head and neck is an extremely rare disease, characterized b y difficult and late diagnosis and poor prognosis; moreover, the definition of primary melanomas of the salivary glands remains controversial. In this paper we describe an unusual case of primary melanoma arising in the parot id gland. A 60-year-old woman presented to us for the persistence of a parotid neopla sm diagnosed as carcinoma by fine-needle aspiration and treated with radiat ion therapy. Wide destructive surgery was performed and immunohistochemical analysis of the surgical specimen led to a diagnosis of melanoma, Complete screening excluded other primary tumor sites. After five years of follow-u p the patient is alive and free of disease. Here we report the diagnostic p rocedures leading to the diagnosis along with a critical analysis of the li terature, emphasizing the difficulties in the diagnosis and classification of melanoma as a primary tumor in the parotid gland and the need for destru ctive surgery.