Resistance and Relapse of Stage III
Malignant Melanoma of the Upper Alveolus

ABHAY MOHAN THAKUR DEPARTMENT OF RADIOTHERAPY AND ONCOLOGY, INDIRA GANDHI COLLEGE, SHIMLA, INDIA

Abstract
A 45-year-old smoker, alcoholic, non-vegetarian man presented in 1997 with a hyperpigmented blackish lesion on the upper alveolus since 1987. He had a past history of trauma to the upper teeth in childhood. Histopathologically malignant melanoma of a demoplastic type was diagnosed. Left upper deep cervical lymphadenopathies developed in 1992 and 1994. The patient was diagnosed clinically with stage III malignant melanoma. Palliative radiotherapy to the growth and bilateral lymphadenopathies were performed in 1998. Nine cycles of chemotherapy (cyclophosphamide, dacarbazine, vincristine, doxorubicin) at 6 weekly intervals were given in 1997 to 1998. A poor response was obtained with chemoradiotherapy. After 3.5 years, in 2002, the patient presented with a relapsed growth at the same place on the upper alveolus, with bilateral upper deep cervical (jugulodiagastric) lymphadenopathy.

Key words: Melanoma, Relapse, Treatment