Malignant Melanoma Arising at the Site of a Previously Excised Giant Congenital Melanocytic Nevus

Coughlin, Carrie C.; Gru, Alejandro A.; Fields, Ryan C.; Bayliss, Susan J.

doi:10.1001/jamadermatol.2013.5775

Cited by 13 publications

(5 citation statements)

References 7 publications

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“…Therefore, the present report highlights the continued risk of malignant transformation during adulthood for this population. Correspondingly, a few other similar cases have been described in the literature, including adults up to 70 years of age who also had undergone partial excision of their lesions ( 17 – 20 ).…”

Section: Discussionmentioning

confidence: 71%

Case report: Later onset of NRAS-mutant metastatic melanoma in a patient with a partially-excised giant congenital melanocytic nevus

et al. 2022

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Despite recent advances in treatment and surveillance, metastatic melanoma still carries a poor prognosis. Large/giant congenital melanocytic nevi (CMNs) constitute a known risk factor for the condition, with the greatest risk for malignant transformation thought to be during childhood (median age at diagnosis of 3 years in a previous cohort). Herein, we present the case of a 30-year-old male who, after undergoing multiple excision/grafting procedures for a giant CMN as a child, was diagnosed with an NRAS-mutant, MDM2-amplified metastatic melanoma more than 20 years later. Response to ipilimumab/nivolumab immunotherapy, cisplatin/vinblastine/temozolomide chemotherapy, and nivolumab/relatlimab immunotherapy was poor. This case highlights the importance of lifetime monitoring with once-yearly dermatological examination (including lymph node palpation) in large/giant CMN patients, as well as the need for further clinical trials evaluating novel therapies for NRAS-mutant melanoma.

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Section: Discussionmentioning

confidence: 71%

Case report: Later onset of NRAS-mutant metastatic melanoma in a patient with a partially-excised giant congenital melanocytic nevus

et al. 2022

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“…The risk of malignant transformation in GCMN has been reported to range between 0% and 42%. [ 7 , 8 ] As above mentioned the GCMN can also bring great psychological and physic damage. All the 5 cases documented here have numerous satellites nevi all over the surface of the body.…”

Section: Discussionmentioning

confidence: 99%

An alternative strategy treated giant congenital melanocytic nevi with epidermis and superficial dermis of the lesions

Wang²,

Luo³

et al. 2018

Medicine

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Giant congenital melanocytic nevi (GCMN) are defined as rare pigmented lesions that are believed to form between weeks 9 and 20 of gestation. It is difficult to reconstruct large defects after the removal of the lesions and it has posed a great challenge to the plastic surgeon and dermatologist.Given all those difficulty reconstructing the defects, we try to explore an alternative way to resurfacing the defect after removal of GCMN.Patients with GCMN received single-stage excision. Following the subcutaneous tissue and deep dermis were discarded, epidermis and superficial dermis were harvested as graft substitutes to reconstruct the defects in situ.All of the grafted tissue survived well and skin color in the surgical area gradually became lighter. During the periodicity of follow-up, neither hypertrophic scars nor recurrence were observed. Furthermore, histopathology examination demonstrated that there are no distinct melanocytes gathered in the postoperation lesions.For those GCMN which is difficult to reconstruct with traditional methods, resection of the lesion followed by reconstruction with epidermis skin and superficial dermis from the lesions in situ may be a feasible and alternative therapy method.

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“…Second, cutaneous melanocytes can be left behind regardless of removal method [39]. Reports of recurrent nevi and MM in patients following even the surgical excision of CMN highlight this phenomenon [43][44][45][46]. Treatment-related scarring may also make developing cutaneous melanoma more difficult to detect [22].…”

Section: Malignant Melanomamentioning

confidence: 99%

“…Functional impairment such as ptosis or scar contracture decreasing joint mobility can occur, particularly for lesions that are large, facial, or overlying joints [21,22,24]. Surgery does not prevent MM [75], and there have been several reports of MM, nevus recurrence, and the development of satellite lesions post-excision [43][44][45][46].…”

Section: Surgical Excisionmentioning

confidence: 99%

Updates in the Management of Congenital Melanocytic Nevi

Mologousis,

Tsai,

Tissera

et al. 2024

Children

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Congenital melanocytic nevi (CMN) carry an increased risk of melanoma and may be disfiguring, and consensus regarding treatment recommendations is lacking. While clinical monitoring is the standard of care, many caregivers are interested in its removal to prevent psychosocial burden or to decrease risk. Although melanoma can occur regardless of CMN removal, there are a variety of treatments that may offer improved cosmesis or local symptom control, including surgical excision, laser therapy, and other superficially destructive techniques. Regardless of the selected management, these patients are monitored for ongoing melanoma risk. An extensive discussion with families regarding the risks and benefits of observation versus active intervention is essential. To facilitate these discussions, we herein summarize current CMN management strategies and considerations.

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Malignant Melanoma Arising at the Site of a Previously Excised Giant Congenital Melanocytic Nevus

Cited by 13 publications

References 7 publications

Case report: Later onset of NRAS-mutant metastatic melanoma in a patient with a partially-excised giant congenital melanocytic nevus

Case report: Later onset of NRAS-mutant metastatic melanoma in a patient with a partially-excised giant congenital melanocytic nevus

An alternative strategy treated giant congenital melanocytic nevi with epidermis and superficial dermis of the lesions

Updates in the Management of Congenital Melanocytic Nevi

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