Oral Melanocytic Neoplasms: A Narrative Review.

INTRODUCTION

Oral melanocytic neoplasms, such as oral melanocytic nevi (OMN), oral dysplastic nevi (ODN), atypical melanocytic proliferation (AMP), and oral mucosal melanoma (OMM), represent < 1% of oral lesions. They are composed of pigment-producing cells with distinct biological behaviors. This study aimed to summarize the clinicopathological and molecular features of these lesions.

METHODS

Studies published in English (1950-2025) were retrieved from the PubMed database and Web of Science Core Collection. All articles presenting clinicopathological and molecular outcomes of OMN, ODN, AMP, and OMM were included. A narrative summary was created to describe the findings.

RESULTS

OMN and OMM are well-described from a clinicopathological perspective. However, ODN and AMP remain scarcely documented. The genetic landscape of OMN suggests a limited role for driver mutations in BRAF or GNAQ , which promote the proliferation of pigmented-producing cells, often insufficient for malignancy. OMM exhibits a distinct molecular profile characterized by a scarcity of MAPK mutations and numerous copy-number changes, as well as amplifications and chromosomal rearrangements. In contrast, no genetic data are available for ODN and AMP.

CONCLUSIONS

Oral melanocytic neoplasms are rare and have distinct clinicopathological features. Despite this, a gap exists in molecular data regarding ODN and AMP. Conversely, OMN and OMM have distinct profiles; in particular, the latter may benefit modestly from tyrosine kinase inhibitor treatment, as KIT and BRAF mutations are sensitive to imatinib and vemurafenib, respectively.