Intramucosal Melanocytic Nevus of Buccal Mucosa: Two Case Reports

Marisa Permpoontanalap, Surawut Pongsiriwet, Jitjiroj Itthichaicharoen, Kittipong Laosuwan, Khanaphot Jiwanarom, Wirada Kornkrasunk, Nattanit Boonsong

Published Online: May 28, 2026 DOI 10.12982/OSR.2026.029

Oral melanocytic nevus is a rare benign lesion in the oral cavity, arising from melanocytes and nevoid cells of neural crest origin. It appears as a blue-to-black, well-defined, round or oval lesion, 1-6 mm, usually asymptomatic. Histopathology shows nevoid cell clusters with melanin, classified into four types: junctional, compound, intramucosal (most common), and blue nevus. Differential diagnosis includes physiologic pigmentation, amalgam tattoo, oral melanotic macule, smoker’s melanosis, and melanoma. Treatment involves observation or excisional biopsy for histopathology. Prognosis is good, with no malignant tendency. This case report enhances understanding of the lesion and emphasizes accurate diagnosis.

intramucosal melanin nevoid cells oral melanocytic nevus oral pigmented lesion

1. Ramesh R, Sadasivan A. Intramucosal melanocytic nevi: a rare cause for gingival enlargement. report of a case and review of literature. Clin Cosmet Investig Dent. 2023;15:71-7.

2. Sreeja C, Ramakrishnan K, Vijayalakshmi D, Devi M, Aesha I, Vijayabanu B. Oral pigmentation: a review. J Pharm Bioallied Sci. 2015;7(Suppl 2):S403-8.

3. Ferreira L, Jham B, Assi R, Readinger A, Kessler HP. Oral melanocytic nevi: a clinicopathologic study of 100 cases. Oral Surg Oral Med Oral Pathol Oral Radiol. 2015;120(3):358-67.

4. Buchner A LA. Pigmented nevi of the oral mucosa: a clinicopathologic study of 36 new cases and review of 155 cases from the literature. part II: analysis of 191 cases. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1987;63(6):676-82.

5. Sun A, Hwang MJ, Jin YT, Chiang CP. Intramucosal nevus on the posterior hard palate. J Dent Sci. 2024;19(4):2438-40.

6. Neville B, Damm DD, Allen C, Chi A. Oral and maxillofacial pathology. 5th ed. St. Louis (MO): Elsevier; 2023.p. 376-7.

7. Natarajan E. Black and brown oro-facial mucocutaneous neoplasms. Head Neck Pathol. 2019;13(1):56-70.

8. Santana T, Queiroz A, Goncales LMC, Andrade NS, Trierveiler M. Focal melanocytic lesions of the oral mucosa: an epidemiological and morphological study. Oral Dis. 2023;29(7):2723-33.

9. WHO Classification of Tumours Editorial Board. Head and Neck Tumours. WHO Classification of Tumours series. 9. 5th ed. Lyon (France): International Agency for Research on Cancer; 2024.

10. Jayasooriya PR, Mendis BRRN, Lombardi T. A Case Series on intraoral blue nevi with a literature review-based clinico-pathologic comparison of intraoral blue nevi with other oral melanocytic nevi. Appl Sci. 2023;13(7):4420.

11. Cerman AA, Altuna IK. Oral Pigmentation. J Pigment Disord. 2016;3(1):1-6.

12. Buchner A L, Merrell PW, Carpenter WM. Melanocytic nevi of the oral mucosa: a clinicopathologic study of 130 cases from northern California. J Oral Pathol Med. 1990;19(5):197-201.

13. Meleti M, Vescovi P, Mooi WJ, van der Waal I. Pigmented lesions of the oral mucosa and perioral tissues: a flowchart for the diagnosis and some recommendations for the management. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2008;105(5):606-16.

14. Bonan PRF, Ribeiro ILA, Andrade ALDL, Rosa MRD. Melanocytic nevus in the buccal mucosa: a case report. Rev Odonto Cienc. 2012;27(4):349-52.

15. Freitas DA BP, Sousa AA, Pereira MM, Oliveira SM, Jones KM. Intramucosal nevus in the oral cavity. J Contemp Dent Pract. 2015;16(1):74-6.

16. Jenzer AC, Pepper T. Oral surgery, biopsies. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jul 17 [updated 2025 Jan].

17. Regezi JA, Sciubba JJ, Jordan RCK. Oral pathology: clinical–pathologic correlations. 7th ed. St. Louis (MO): Elsevier;2021.

18. Ficarra G L, Engebretsen S, Levin LS. Combined nevi of the oral mucosa. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1987;63(2):196-201.

19. Pandey P, Chaudhary CP, Ansari AA, Singh R. Intramucosal nevus of buccal mucosa in a male child. BMJ Case Rep. 2013;2013. doi: 10.1136/bcr-2013-010191.

20. Nagarajan J, Raghuram S, Bandalore SH, Patil S. Intramucosal nevus as a lesion on the lip: a case report. J Indian Acad Oral Med Radiol. 2016;28(1):48-51.

21. Buchner A, Merrell PW, Carpenter WM. Relative frequency of solitary melanocytic lesions of the oral mucosa. J Oral Pathol Med. 2004;33(9):550-7.

22. Cohen Y, Goldenberg-Cohen N, Akrish S, Shani T, Amariglio N, Dratviman-Storobinsky O, et al. BRAF and GNAQ mutations in melanocytic tumors of the oral cavity. Oral Surg Oral Med Oral Pathol Oral Radiol. 2012;114(6):778-84.

23. Albagieh H, Alrashed KW, AlGammlas MY, Khormi H, Hodan FM, Alem MF, et al. Oral blue nevus of the lingual gingiva: a case report. Cureus. 2025;17(1):e77405.

24. Thomson P. Oral pigmented lesions: a pragmatic approach to diagnosis and management. Fac Dent J. 2024;15(3):90-6.

25. Tarakji B, Umair A, Prasad D, Alsakran Altamimi M. Diagnosis of oral pigmentations and malignant transformations. Singapore Dent J. 2014;35C:39-46.

Permpoontanalap M, Pongsiriwet S, Itthichaicharoen J, Laosuwan K, Jiwanarom K, Kornkrasunk W, Boonsong N. Intramucosal Melanocytic Nevus of Buccal Mucosa: Two Case Reports: A case reports/series. Oral Sci Rep [Internet]. 2026 May 28 [cited 2026 May 28];47(2):266-271. Available from: https://www.dent.cmu.ac.th/cmdj/frontend/web/?r=site/viewarticle&id=553

Permpoontanalap, M., Pongsiriwet, S., Itthichaicharoen, J., Laosuwan, K., Jiwanarom, K., Kornkrasunk, W. & Boonsong, N. (2026). Intramucosal Melanocytic Nevus of Buccal Mucosa: Two Case Reports. Oral Sci Rep, 47(2), 266-271. Retrieved from: https://www.dent.cmu.ac.th/cmdj/frontend/web/?r=site/viewarticle&id=553

Permpoontanalap, M., Surawut Pongsiriwet,Jitjiroj Itthichaicharoen,Kittipong Laosuwan,Khanaphot Jiwanarom,Wirada Kornkrasunk and Nattanit Boonsong. 2026. "Intramucosal Melanocytic Nevus of Buccal Mucosa: Two Case Reports." Oral Sci Rep, 47(2), 266-271. https://www.dent.cmu.ac.th/cmdj/frontend/web/?r=site/viewarticle&id=553

Permpoontanalap, M. et al. 2026. 'Intramucosal Melanocytic Nevus of Buccal Mucosa: Two Case Reports', Oral Sci Rep, 47(2), 266-271. Retrieved from https://www.dent.cmu.ac.th/cmdj/frontend/web/?r=site/viewarticle&id=553

Permpoontanalap, M., Pongsiriwet, S., Itthichaicharoen, J., Laosuwan, K., Jiwanarom, K., Kornkrasunk, W. and Boonsong, N. "Intramucosal Melanocytic Nevus of Buccal Mucosa: Two Case Reports", Oral Sci Rep, vol.47, no. 2, pp. 266-271, May. 2026.

Permpoontanalap, M., Pongsiriwet, S., Itthichaicharoen, J., et al. "Intramucosal Melanocytic Nevus of Buccal Mucosa: Two Case Reports." Oral Sci Rep, vol.47, no. 2, May. 2026, pp. 266-271, https://www.dent.cmu.ac.th/cmdj/frontend/web/?r=site/viewarticle&id=553