Objective:

To report a unique case of mucosal melanoma of the hard palate, a rare and aggressive malignancy, presenting with gastrointestinal symptoms and to highlight the diagnostic value of 18F-FDG PET/CT.

Approach:

• Patient Presentation: A 60-year-old male presented with chronic gastrointestinal discomfort and underwent various imaging studies.
• Diagnostic Imaging: A whole-body 18F-FDG PET/CT scan revealed a hypermetabolic primary lesion in the hard palate and extensive metastases.
• Histopathological Analysis: Biopsies confirmed the diagnosis of oral melanoma with metastases to the liver, stomach, and bones.

Key Findings:

• Mucosal melanoma is rare and aggressive, often diagnosed at advanced stages due to non-specific symptoms.
• 18F-FDG PET/CT is highly sensitive in detecting occult primary mucosal melanomas.
• The patient presented with gastrointestinal symptoms rather than typical oral symptoms, leading to diagnostic delays.

Interpretation:

This case highlights the importance of comprehensive examinations and the utility of advanced imaging techniques in diagnosing rare malignancies.

Limitations:

• The study is based on a single case report, limiting generalizability.
• The patient's advanced disease at diagnosis may not represent typical presentations of mucosal melanoma.

Conclusion:

The findings emphasize the critical role of 18F-FDG PET/CT in the early diagnosis and staging of mucosal melanoma.