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

Objective: The objective of this review is to determine what size congenital melanocytic nevi (CMN) increases the risk of malignant melanoma in affected patients.Background: Congenital melanocytic nevi are benign proliferations of cutaneous melanocytes apparent at birth or in the first postnatal weeks. The Kopf system classifies nevi based on size: small, <1.5 cm in diameter; medium, 1.5–19.9 cm in diameter, and large, ≥20 cm in diameter. Great variability exists in quantifying the risk of malignant transformation from congenital nevi of different sizes. Evidence-based standard guidelines for clinical investigation need to be established. Methods: Literature search included studies on medium, large, and giant congenital nevi in association with melanoma.Results: Three studies pertaining to small, medium, and large congenital nevi are defined. The odds ratio of malignant transformation from small CMN was determined to be 20.9 by history and 10.5 by histology in 238 patients in the case-control study selected. No malignant transformation was found in a prospective study of 230 individuals with medium-sized melanocytic nevi. Finally, a 5% risk of malignant transformation was reported in a prospective study of patients with large congenital nevi.Conclusion: All patients should receive total body skin and mucosal surface exams. Patients with small CMN (<1.5 cm in diameter) and medium CMN (≥1.5 cm–19.9 cm in diameter) should be closely observed over their lifetimes and given the option of specialist referral. Finally, patients with large CMN (≥20 cm in diameter) should be referred to specialists upon initial presentation. More original data and follow-up are needed for maturation of evidence-based clinical recommendations.

Download Full-text

Giant Congenital Melanocytic Nevi: An Update and Emerging Therapies

Case Reports in Dermatology ◽

10.1159/000487002 ◽

2018 ◽

Vol 10 (1) ◽

pp. 24-28 ◽

Cited By ~ 3

Author(s):

Girish Gulab Meshram ◽

Neeraj Kaur ◽

Kanwaljeet Singh Hura

Keyword(s):

Hydrostatic Pressure ◽

Malignant Melanoma ◽

Rare Occurrence ◽

Review Of The Literature ◽

Neurocutaneous Melanosis ◽

Melanocytic Nevi ◽

Emerging Therapies ◽

Giant Congenital Melanocytic Nevi ◽

Congenital Melanocytic Nevi

Giant congenital melanocytic nevi (GCMN) are a rare occurrence. Gain-of-function mutation in the NRAS gene is found to be associated with GCMN, causing abnormal proliferation of embryonic melanoblasts. The two major complications associated with GCMN are malignant melanoma and neurocutaneous melanosis. Treatment of GCMN has conventionally been surgical. However, the role of NRAS inhibitors and inactivation of nevus tissue by high hydrostatic pressure are being explored. We present a case of a 1-day-old neonate born with GCMN, along with a review of the literature.

Download Full-text

Potential for Development of Malignant Melanoma with Congenital Melanocytic Nevi

Journal of Craniofacial Surgery ◽

10.1097/01.scs.0000180487.65784.a1 ◽

2005 ◽

Vol 16 (5) ◽

pp. 871-873 ◽

Cited By ~ 3

Author(s):

Justin Yovino ◽

Seth Thaller

Keyword(s):

Malignant Melanoma ◽

Melanocytic Nevi ◽

Congenital Melanocytic Nevi

Download Full-text

Malignant melanoma arising in congenital melanocytic nevi: clinical and dermoscopic challenges

Our Dermatology Online ◽

10.7241/ourd.20171.8 ◽

2017 ◽

Vol 8 (1) ◽

pp. 34-36

Author(s):

Fatma Pelin Cengiz ◽

Nazan Emiroglu ◽

Anil Gulsel Bahali ◽

Ozlem Su ◽

Nahide Onsun

Keyword(s):

Malignant Melanoma ◽

Melanocytic Nevi ◽

Congenital Melanocytic Nevi

Download Full-text

Giant congenital melanocytic nevi (garment variety): a case report

International Journal of Contemporary Pediatrics ◽

10.18203/2349-3291.ijcp20213333 ◽

2021 ◽

Vol 8 (9) ◽

pp. 1625

Author(s):

Om Prakash Singh ◽

Vikas Kumar ◽

Rahul Kumar

Keyword(s):

Malignant Melanoma ◽

Psychological Intervention ◽

Skin Lesions ◽

Melanocytic Nevus ◽

Congenital Melanocytic Nevus ◽

Melanocytic Nevi ◽

Black Skin ◽

Giant Congenital Melanocytic Nevi ◽

And Migration ◽

Congenital Melanocytic Nevi

Giant congenital melanocytic nevi (GCMN) are large brown-to-black skin lesions caused due to genetic mutations which lead to defective proliferation, differentiation and migration of melanoblasts which are precursor cells of melanocytes. There is a mutation in the NRAS gene causing abnormal proliferation of embryonic melanoblasts. Congenital melanocytic nevus is primarily a clinical diagnosis. The malignant melanoma and neurocutaneous melanosis are the two major complications associated with GCMN. The risk of transformation of GCMN to malignant melanoma varies between 0 and 3.8%. About 1% of live births presents with a CMN. The incidence of GCMN is estimated at less than 1: 20,000 newborns. The variety ‘garment-like’ of GCMN is even scarcer, 1: 5,00,000. GCMN has got major psychosocial impact on the patient and his family due to its unsightly appearance. Treatment includes surgical and non-surgical procedures, psychological intervention and clinical follow-up, with special attention to changes in color, texture on the surface of the lesion. We presented a case of 1-day-old female neonate born with GCMN in our hospital.

Download Full-text

Artificial Skin INTEGRA Use in the Treatment of Large Melanocytic Nevi

Lietuvos chirurgija ◽

10.15388/lietchirur.2020.19.27 ◽

2020 ◽

Vol 19 (1-2) ◽

pp. 62-70

Author(s):

Dainius Geležauskas ◽

Rūta Dubosaitė

Keyword(s):

Malignant Melanoma ◽

University Hospital ◽

Artificial Skin ◽

Skin Substitute ◽

Radical Excision ◽

Melanocytic Nevi ◽

Malignant Skin ◽

Risk Of Malignancy ◽

Vilnius University ◽

Congenital Melanocytic Nevi

Melanocytic nevi are congenital, benign, pigmented proliferations. They have high risk of malignancy, most frequently transform to malignant skin melanoma and 70% it occurs in the first life decade. The risk of malignant transformation increases proportionately to their size. The best way to avoid those risks is early and radical excision. In 1996 on the market appeared the Integra™ artificial skin, has made it possible to improve the methods for the elimination of large congenital nevi and significantly reduce the risk of malignant melanoma, at an early age. 2011–2019, in Children’s Hospital, Affiliate of Vilnius University Hospital Santaros Clinics, the Integra™ was used to treat congenital melanocytic nevi in four children. Implantation of the skin substitute Integra™ has been successful for all the patients, the prognosis was good. The treatment of congenital melanocytic nevi is a necessity to avoid the risk of developing malignant melanoma. The rarity of this condition has led to the fact that so far there is no universal approach for all the cases. Integra™ artificial skin is an excellent choice for the treatment of congenital melanocytic nevi, especially for paediatric patients.

Download Full-text

Medium-Sized Congenital Melanocytic Nevus with Halo Phenomenon: A Report of Two Cases

SKIN The Journal of Cutaneous Medicine ◽

10.25251/skin.5.4.16 ◽

2021 ◽

Vol 5 (4) ◽

pp. 426-429

Author(s):

Antara Afrin ◽

Lori Kim ◽

Kurt Ashack ◽

Thomas Klis ◽

Michelle Bain

Keyword(s):

Malignant Melanoma ◽

Clinical Finding ◽

Melanocytic Nevus ◽

Medium Size ◽

Congenital Melanocytic Nevus ◽

Malignant Growth ◽

Melanocytic Nevi ◽

Congenital Melanocytic Nevi

Congenital melanocytic nevi with halo phenomenon in children is a rare clinical finding. We report two cases of children who developed depigmentation within medium-size congenital melanocytic nevi. Clinicians should be suspicious when confronted with this phenomenon due to the risk of development into malignant melanoma. Herein, we review these rare cases of medium-sized halo congenital melanocytic nevi with and without associated vitiligo, with emphasis that depigmentation does not necessarily indicate malignant growth.

Download Full-text