{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T14:08:20Z","timestamp":1785247700851,"version":"3.55.0"},"reference-count":14,"publisher":"BMJ","issue":"7","license":[{"start":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T00:00:00Z","timestamp":1785196800000},"content-version":"unspecified","delay-in-days":27,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Shimane University Hospital Advanced Medical Care Promotion Fund"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2026,7,15]]},"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:p>Oral malignant melanoma (OMM) is a rare and aggressive malignancy, and involvement of the tongue is particularly uncommon. We report a case presenting with two isolated pigmented tongue lesions clinically resembling benign conditions. Excisional biopsy of the anterior lesion confirmed melanoma, and the tongue base lesion was clinically suspected to represent possible in-transit metastasis. To our knowledge, in-transit metastasis in OMM is not well documented. The patient underwent wide local excision followed by adjuvant pembrolizumab based on cutaneous melanoma guidelines. Final pathological staging was pT3b pN1c cM0 (stage IIIC). At 1-year follow-up, no recurrence or metastasis was observed and oral function was preserved with a palatal augmentation prosthesis. This case highlights diagnostic challenges and the importance of early biopsy and multidisciplinary management. Additional cases and further multicentre studies are needed to validate these observations and guide the development of standardised treatment protocols in the diagnosis and management of OMM.<\/jats:p>","DOI":"10.1136\/bcr-2026-273855","type":"journal-article","created":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T13:30:20Z","timestamp":1785245420000},"page":"e273855","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Oral malignant melanoma of the tongue with suspected intralingual in-transit metastasis"],"prefix":"10.1136","volume":"19","author":[{"given":"Reon","family":"Morioka","sequence":"first","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery, Shimane University Faculty of Medicine, Izumo, Shimane, Japan"},{"name":"Department of Pharmacology, Shimane University Faculty of Medicine, Izumo, Shimane, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masako","family":"Fujioka-Kobayashi","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery, Shimane University Faculty of Medicine, Izumo, Shimane, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroto","family":"Tatsumi","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery, Shimane University Faculty of Medicine, Izumo, Shimane, Japan"},{"name":"Shimane University Hospital Innovative Cancer Centre, Izumo, Shimane, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuhei","family":"Matsuda","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery, Shimane University Faculty of Medicine, Izumo, Shimane, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rie","family":"Osako-Sonoyama","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery, Shimane University Faculty of Medicine, Izumo, Shimane, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michitaka","family":"Somoto","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery, Shimane University Faculty of Medicine, Izumo, Shimane, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takahiro","family":"Kanno","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery, Shimane University Faculty of Medicine, Izumo, Shimane, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,7,28]]},"reference":[{"key":"2026072806301506000_19.7.e273855.1","doi-asserted-by":"publisher","DOI":"10.1016\/S1368-8375(99)00085-8"},{"key":"2026072806301506000_19.7.e273855.2","doi-asserted-by":"crossref","first-page":"1132","DOI":"10.1016\/S0278-2391(03)00670-0","article-title":"Primary malignant melanoma of the oral mucosa","volume":"61","author":"Rapidis","year":"2003","journal-title":"J Oral Maxillofac Surg"},{"key":"2026072806301506000_19.7.e273855.3","doi-asserted-by":"crossref","first-page":"606","DOI":"10.1016\/j.tripleo.2007.07.047","article-title":"Pigmented lesions of the oral mucosa and perioral tissues: a flow-chart for the diagnosis and some recommendations for the management","volume":"105","author":"Meleti","year":"2008","journal-title":"Oral Surg Oral Med Oral Pathol Oral Radiol Endod"},{"key":"2026072806301506000_19.7.e273855.4","doi-asserted-by":"publisher","DOI":"10.1002\/hed.23872"},{"key":"2026072806301506000_19.7.e273855.5","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2009.23.4799"},{"key":"2026072806301506000_19.7.e273855.6","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-018-6513-7"},{"key":"2026072806301506000_19.7.e273855.7","unstructured":"National Comprehensive Cancer Network . NCCN clinical practice guidelines in oncology: cutaneous melanoma. version 1. 2025. Available: https:\/\/www.nccn.org [Accessed 10 Jan 2026]."},{"key":"2026072806301506000_19.7.e273855.8","first-page":"682","article-title":"Pigmented lesions of the oral cavity: review, differential diagnosis, and case presentations","volume":"70","author":"Kauzman","year":"2004","journal-title":"J Can Dent Assoc"},{"key":"2026072806301506000_19.7.e273855.9","doi-asserted-by":"publisher","DOI":"10.1097\/00000478-200207000-00006"},{"key":"2026072806301506000_19.7.e273855.10","doi-asserted-by":"crossref","first-page":"158","DOI":"10.1016\/j.anl.2019.03.003","article-title":"Medial lingual lymph node metastasis in carcinoma of the tongue","volume":"47","author":"Eguchi","year":"2020","journal-title":"Auris Nasus Larynx"},{"key":"2026072806301506000_19.7.e273855.11","doi-asserted-by":"crossref","first-page":"65","DOI":"10.3315\/jdcr.2008.1015","article-title":"Dermoscopy of pigmented lesions of the oral mucosa and lips: current knowledge","volume":"2","author":"Olszewska","year":"2008","journal-title":"J Dermatol Case Rep"},{"key":"2026072806301506000_19.7.e273855.12","doi-asserted-by":"publisher","DOI":"10.1097\/00005537-200202000-00032"},{"key":"2026072806301506000_19.7.e273855.13","doi-asserted-by":"publisher","DOI":"10.1016\/j.prosdent.2003.10.012"},{"key":"2026072806301506000_19.7.e273855.14","doi-asserted-by":"crossref","first-page":"S176","DOI":"10.1017\/S0022215116000608","article-title":"Speech and swallow rehabilitation in head and neck cancer: United Kingdom National Multidisciplinary Guidelines","volume":"130","author":"Clarke","year":"2016","journal-title":"J Laryngol Otol"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2026-273855","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T13:30:23Z","timestamp":1785245423000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2026-273855"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7]]},"references-count":14,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2026,7,28]]},"published-print":{"date-parts":[[2026,7]]}},"alternative-id":["10.1136\/bcr-2026-273855"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2026-273855","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7]]}}}