Pembrolizumab for Gingival Melanoma: A Spectacular Response in a Challenging Case

Malignant melanomas of the oral cavity are extremely rare tumors. The mandibular mucosa is the most frequent site for melanomas of the oral cavity. Although they are easy to detect due to their pigmentation and irregular shapes and contours, diagnosis is often delayed and only occurs in cases of ulceration or hemorrhage of the overlying epithelium. This late detection is the cause of poor prognosis. Mucosal Melanoma (MM) in general, and gingival melanoma in particular, represents a significant clinical challenge due to its aggressive nature and limited treatment options. Immunotherapy is a promising strategy for these melanomas, with a particular focus on immune checkpoint inhibitors, such as PD-1 inhibitors. We will report the case of a 70-year-old female patient who presented with gingival melanoma, and discuss through this case the diagnostic pitfalls and therapeutic options of this rare pathology.