A 58-year-old Japanese man with a BN presented with a 5-year history of a blue-black macule on the hard palate. The patient had no malignant signs, no abnormal radiologic findings in the maxillofacial region, or abnormal laboratory values. Histopathology showed parallel spindle-shaped melanocytes under the epithelium with fibrosis. A BN was diagnosed. The 2-year follow-up and clinical outcome were satisfactory, without recurrence or complications.
Close monitoring and long-term follow-up or early biopsy to exclude OMM in the oral cavity are important in cases in which the diagnosis is not definitive clinically.