Blue nevus of the hard palate: A case report

Oral pigmentation ranges from physiologic pigmentation to malignant neoplasms. Blue nevi (BN), benign melanocytic lesions that rarely develop in the oral cavity, can be associated with malignant melanoma. Although most oral pigmented lesions are benign, long-term follow-up/histopathologic evaluation eliminate oral malignant melanoma (OMM) when lesions develop in the most frequent sites (palate and maxillary gingiva).A 58-year-old Japanese man with a BN presented with a 5-year history of a blue-black macule on the hard palate. The patient had no malignant signs, no abnormal radiologic findings in the maxillofacial region, or abnormal laboratory values. Histopathology showed parallel spindle-shaped melanocytes under the epithelium with fibrosis. A BN was diagnosed. The 2-year follow-up and clinical outcome were satisfactory, without recurrence or complications.Close monitoring and long-term follow-up or early biopsy to exclude OMM in the oral cavity are important in cases in which the diagnosis is not definitive clinically.