Primary malignant melanoma of the tongue CJS Lingual melanotic macule the first case report in an adult patient* Anais Brasileiros de Dermatologia What Caused These Multiple Hyperpigmented Macules of the Mouth? Brown spots, especially on the lips, can be alarming to some. In some instances it can indicate rare oral mucosal melanoma, however in this case it was a non cancerous labial melanotic macule. 05 May 03 Eng