The Incidence of Malignant Transformation in Giant Pigmented Nevi

Abstract

151 patients with benign giant pigmented nevi registered in the Danish Health system during the 60-year period 1915-75 were retrieved via the national register. A questionnaire was sent to all surviving patients asking for information about their health and especially whether they had had any treatment or had observed any changes in the nevus. All of the patients replied to the questionnaire. No patients had been cured from malignancy or were alive with known malignancy. Three patients had died from malignant melanoma during the period of observation. These case histories are reported. It is calculated that 4.6% of the patients with congenital giant nevi should be expected to develop malignant melanoma provided the incidence is the same in all age groups. Some uncertainty remains on account of the limited number of cases and an unsettled question about a higher incidence in childhood.

Nevus congénito pigmentado piloso gigante

“…Nevertheless, it has been proven that they can eventually turn into malignant melanoma. The relationship between melanoma and giant nevomelanocytic nevi is well reported and the risk of developing a melanoma is proportional to the size of the nevus, with an increased risk for those patients with nevi affecting more than 5% of the body surface 4,5 . The treatment mostly depends of the size, the localization and the potential of malignization of the condition (changes in size, skin or subcutaneous nodules with very dark pigmentation, itching, pain, bleeding or ulceration).…”

Curettage of Giant Congenital Melanocytic Nevi in Neonates

“…have an increased malignancy risk, estimated to be around 5% [2][3][4]12,13 ; 50% of malignant degeneration in these nevi occurs before puberty and most often in the first years of life. Additional reasons to remove these lesions early is that they are disfiguring lesions that can be an aesthetic tragedy and contribute to severe psychological sequelae.…”

“…[1][2][3] Most authorities agree to remove these nevi whenever possible and as early as possible. 4,5 Unfortunately, these lesions are mostly too large to be removed by classic surgery.…”

Congenital giant pigmented nevi: Clinical features and risk of malignancy

“…On reviewing the literature (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15), the risk of malignancy varied from 0% to 42% (Table 1). This variability reflects the relative rarity of CGPN and that different studies have looked at different patient populations and different age groups.…”

“…Unfortunately, this is not clinically feasible. Lorentzen et al (8) retrieved reports from 151 patients with CGPN registered in the Danish Health System during a 60-year period and found three cases of malignant transformation. However, one of these three cases was a 28-year-old female with sarcoma arising in her CGPN.…”