Large Congenital Melanocytic Nevi and the Risk for Development of Malignant Melanoma and Neurocutaneous Melanocytosis

Bittencourt, Flávia Vasques; Marghoob, Ashfaq A.; Kopf, Alfred W.; Koenig, Karen L.; Bart, Robert S.

doi:10.1542/peds.106.4.736

Cited by 278 publications

(218 citation statements)

References 30 publications

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“…24 Large congenital melanocytic nevi have an increased risk for the development of cutaneous and extracutaneous melanomas. [24][25][26] The overall incidence of malignant transformation of congenital melanocytic nevi ranges from 0.025 to 5.9% in different studies (2-42% in large congenital nevi) with very high risk during the first decade of life. 25,26 The expression of fatty acid synthase in congenital nevi could represent either persistence of or regression to a fetal immunophenotype, since it is known that fetal cells express high levels of fatty acid synthase.…”

Section: Discussionmentioning

confidence: 99%

“…[24][25][26] The overall incidence of malignant transformation of congenital melanocytic nevi ranges from 0.025 to 5.9% in different studies (2-42% in large congenital nevi) with very high risk during the first decade of life. 25,26 The expression of fatty acid synthase in congenital nevi could represent either persistence of or regression to a fetal immunophenotype, since it is known that fetal cells express high levels of fatty acid synthase. 1 The strong expression of fatty acid synthase in congenital nevi is not diagnostically helpful in the setting of malignant melanoma arising in congenital nevi.…”

Section: Discussionmentioning

confidence: 99%

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Fatty acid synthase expression in cutaneous melanocytic neoplasms

et al. 2005

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Mammalian fatty acid synthase is a multifunctional enzyme complex involved in de novo synthesis of saturated fatty acids, and inhibitors of fatty acid synthase are being evaluated as potential therapeutic agents. Increased fatty acid synthase expression has been demonstrated in subsets of malignancies, including colon, breast, endometrium, prostate and ovarian carcinomas, and recently malignant melanomas. We evaluated the immunohistochemical expression of fatty acid synthase in 155 cutaneous melanocytic lesions. They included 30 congenital nevi, 19 compound nevi, 40 Spitz nevi, 48 primary melanomas, and 18 metastatic melanomas. Fatty acid synthase expression was stronger in malignant melanomas in comparison to conventional nevi and Spitz nevi, and was the highest for metastatic melanoma. Of the primary malignant melanomas, mean fatty acid synthase scores were significantly greater for Clark levels IV and V compared to Clark levels I and II (Po0.001). In addition, melanomas with Breslow thickness 0.75-1.50 mm and 41.50 mm showed significantly higher mean fatty acid synthase scores compared with those with Breslow thickness o0.75 mm (P ¼ 0.013 and o0.001, respectively). Of interest, congenital melanocytic nevi also showed strong fatty acid synthase expression, similar to that seen in metastatic melanoma. This may represent persistence of or regression to a fetal phenotype since normal fetal tissues are known to express high levels of fatty acid synthase.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Fatty acid synthase expression in cutaneous melanocytic neoplasms

et al. 2005

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“…Factors often associated with the risk of malignant degeneration include location of the lesion, presence of neurocutaneous melanocytosis, and depth and distribution of the pigmentation. However, the risk of malignancy seems to be lower than previously reported, now expressed as a life-risk range of 2.3%, with most cases tending to occur before adolescence (1)(2)(3)(4)(5)(6)(7).…”

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confidence: 67%

Congenital giant nevocellular nevus of the back with deep extension to the fat and fascia

Jaeger¹

2006

CAN J PLAST SURG

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MRO Jaeger, RM Zuker. Congenital giant nevocellular nevus of the back with deep extension to the fat and fascia. Can J Plast Surg 2006;14(1):45-48.The presence of deep pigmentation in a giant congenital nevus makes its complete removal very difficult and should be taken into consideration when planning for treatment. A clinical case in which the pigmented lesion was found to extend deep into the muscle fascia is described. The lesion was surgically removed with an acceptable functional and aesthetic result through the utilization of tissue expansion. The development of new surgical techniques and the expansion of laser technology will possibly provide new treatment options in the future. Emphasis should be placed on aesthetics and function, because the excision based only on oncological anticipation is no longer valid. The presence of deep pigmentation makes certain treatment options less effective than surgical ablation.Key Words: Giant congenital nevi; Laser; Tissue expanders Naevus cellulaire congénital géant dans le dos, avec pénétration profonde dans le tissu adipeux et le fascia La présence d'une pigmentation profonde dans un naevus congénital géant rend son excision complète très difficile, et cet aspect devrait être pris en considération lorsque vient le moment de planifier le traitement. Voici un cas clinique de lésion pigmentée avec pénétration profonde dans le fascia. La lésion a été excisée convenablement des points de vue fonctionnel et esthétique par le recours à des expanseurs tissulaires. La mise au point de nouvelles techniques chirurgicales et le développement de la technologie laser déboucheront peut-être sur l'élaboration d'autres traitements. Une attention particulière devrait être portée aux aspects esthé-tique et fonctionnel, parce qu'aujourd'hui l'excision fondée sur le seul critère de la prévision oncologique ne suffit plus. La présence d'une pigmentation profonde rend certains traitements moins efficaces que l'excision chirurgicale.

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“…The pathological classification is based on the location of the melanocytes: dermal (dermis), junctional (dermalepidermal junction) and compound (involving both dermis and dermal-epidermal junction). [69] There is a small possibility of malignant transformation of large melanocytic nevi, [70] and surgical excision should be curative. [71] Penile vascular anomalies and neurogenic lesions Vascular anomalies involving the male genitalia can cause considerable distress, adversely impact a patient's self-image, inflict pain, and alter function.…”

Section: Penile Nevimentioning

confidence: 99%

Benign penile skin anomalies in children: a primer for pediatricians

et al. 2015

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Background: Abnormalities involving the skin coverage of the penis are diffi cult to defi ne, but they can significantly alter penile appearance, and be a cause of parental concern.Data sources: The present review was based on a nonsystematic search of the English language medical literature using a combination of key words including "penile skin anomalies" and the specific names of the different conditions.Results: Conditions were addressed in the following order, those mainly affecting the prepuce (phimosis, balanitis xerotica obliterans, balanitis, paraphimosis), those which alter penile configuration (inconspicuous penis and penile torsion), and lastly focal lesions (cysts, nevi and vascular lesions). Most of these anomalies are congenital, have no or minimal influence on urinary function, and can be detected on clinical examination. Spontaneous improvement is possible. In the majority of cases undergoing surgery, the potential psychological implications of genital malformation on patient development are the main reason for treatment, and the age generally recommended for surgery is after 12 months of age. Conclusion:This review provides the pediatrician with a handy tool to identify the most common penile skin anomalies, counsel parents adequately, make sensible and evidence based choices for management, and recognize complications or untoward outcomes in patients undergoing surgery. World J Pediatr March 2015; Online First

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Large Congenital Melanocytic Nevi and the Risk for Development of Malignant Melanoma and Neurocutaneous Melanocytosis

Abstract: Patients with large congenital melanocytic nevi are at increased risk for developing melanomas. There is also a significant increased risk for developing NCM. The high incidence of CNS involvement may influence decisions concerning treatment of the large congenital melanocytic nevi.

Cited by 278 publications

References 30 publications

Fatty acid synthase expression in cutaneous melanocytic neoplasms

Fatty acid synthase expression in cutaneous melanocytic neoplasms

Congenital giant nevocellular nevus of the back with deep extension to the fat and fascia

Benign penile skin anomalies in children: a primer for pediatricians

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