Common and not so Common Melanocytic Lesions in Children and Adolescents

The acquired melanocytic nevus is the most common lesion encountered by pediatric pathologists and dermatopathologists in their daily practice. In most cases, there are few difficulties in histopathologic diagnosis. However, it is the acquired melanocytic lesion known as the Spitz nevus, with its intrinsic atypical features which becomes the challenge since it exists along a histopathologic and biologic continuum from the atypical Spitz tumor to spitzoid melanoma. The frustration with some of these spitzoid lesions is that even the “experts” cannot agree as to the differentiation of one from the other even at the level of molecular genetics. Other melanocytic lesions are discussed including the congenital melanocytic nevus with its proliferative nodule(s) and melanoma as the ultimate complication. Although uncommon, cutaneous melanoma in the first 2 decades is emerging as a clinical problem especially in young women in the second decade of life. These are ultraviolet-associated neoplasms whose histopathologic and prognostic features are identical to the adult experience. Considerable progress has been made over the past 15 to 20 years in our understanding of cutaneous melanocytic lesions, but gaps still exist in the important group of spitzoid lesions. It can also be anticipated that more cutaneous melanomas in children will be seen in the future based upon epidemiologic studies.

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Congenital Melanocytic Nevus and Fibroepithelioma of Pinkus: A Rare Type of Collision Tumor

Nepal Journal of Dermatology Venereology & Leprology ◽

10.3126/njdvl.v19i1.35955 ◽

2021 ◽

Vol 19 (1) ◽

pp. 81-83

Author(s):

Anil Kumar Bhatta ◽

Uma Keyal ◽

Yeqiang Liu

Keyword(s):

Collision Tumor ◽

Melanocytic Nevus ◽

Melanocytic Lesion ◽

Congenital Melanocytic Nevus ◽

Rare Type ◽

Pigmented Lesion

Congenital melanocytic nevus is benign pigmented lesion of the skin usually present at birth. Here we report a case of 61-year-old male who presented with a pigmented lesion on the trunk, which on biopsy showed features of both congenital melanocytic nevus and fibroepithelioma of Pinkus. We reviewed literature for this combination and found only one case reported so far. Hence, it seems that it is very unusual to seefibroepithelioma of Pinkus in conjunction with a melanocytic lesion.

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Giant congenital melanocytic nevus: a rare case report

International Journal of Contemporary Pediatrics ◽

10.18203/2349-3291.ijcp20204407 ◽

2020 ◽

Vol 7 (11) ◽

pp. 2236

Author(s):

Arty Tyagi ◽

Bipin Kumar ◽

Mani Kant Kumar

Keyword(s):

Rare Case ◽

Melanocytic Nevus ◽

Melanocytic Lesion ◽

Congenital Melanocytic Nevus ◽

Melanocytic Nevi ◽

Rare Case Report ◽

Giant Congenital Melanocytic Nevi ◽

Magnetic Resonance Imaging Mri ◽

Congenital Melanocytic Nevi ◽

Giant Congenital Melanocytic Nevus

Giant congenital melanocytic nevus is usually defined as a melanocytic lesion present a birth. Its incidence is estimated in <1 in 20,000 newborns. Despite its rarity, this lesion is important because it may be associate with severe complications such as malignant melanoma and may also cause neurological deficit including neurocutaneous melanocytosis. Giant congenital melanocytic nevus generally present as a brown lesion with flat or mammilated surface, well-demarcated borders and hypertrichiosis. Congenital melanocytic nevus is primarily a clinical diagnosis. Recently, we encountered a 3 day old baby girl in whom giant congenital melanocytic nevi was noted at birth. She presented with large nevus over posterior trunk, head and extremities. Magnetic resonance imaging (MRI) brain was normal. Parents were counselled regarding possible future course and were asked to be in regular follow-up. Here, we report this rare case with giant congenital melanocytic nevi.

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Meyerson Nevus Mimicking Malignant Melanoma

Gazeta Médica ◽

10.29315/gm.v5i4.216 ◽

2018 ◽

Author(s):

Filipa Tavares Almeida ◽

Regina Caldas ◽

Teresa Pereiro ◽

Celeste Brito

Keyword(s):

Case Report ◽

Malignant Melanoma ◽

Sun Exposure ◽

Melanocytic Nevus ◽

Melanocytic Lesion ◽

Melanocytic Lesions ◽

Histopathological Evaluation ◽

Intense Pruritus

Meyerson nevus represents an uncommon clinical and histological variation of melanocytic lesions that is characterized by an eczematous halo surrounding a melanocytic nevus.1It was first reported by Meyerson and it typically clears spontaneously or resolves with topical corticotherapy.2We report the case of an atypical Meyerson nevus in which, despite intense pruritus, both an eczematous eruption and dermoscopic patterns imputable to a melanocytic lesion were lacking. 1. Balato A, Lembo S, Cirillo T, Megna M, Napolitano M, Balat N. Meyerson phenomenon around naevi: resolution after sun exposure? Acta Dermato-Venereol. 2011; 91:352-3. doi: 10.2340/00015555-1059.2. Gabbi TV, Omar ED, Criado PR, Valente NY, Martins JE. Clinical, dermoscopic and histopathological evaluation of the Meyerson nevus: case report. An Bras Dermatol. 2010;85:681-3.

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Three Years Retrospective Study of Melanocytic Lesion in Tertiary Hospital: Comparing Benign & Malignant Data

eJournal Kedokteran Indonesia ◽

10.23886/ejki.9.10.24 ◽

2021 ◽

Vol 9 (1) ◽

pp. 24

Author(s):

Fitri Ayu Ramadhini

Keyword(s):

Malignant Melanoma ◽

Tertiary Hospital ◽

Melanocytic Nevus ◽

Melanocytic Lesion ◽

Request Form ◽

Skin Symptom ◽

Pigmented Lesion ◽

Melanocytic Lesions ◽

Fourth Decade ◽

Anatomical Pathology

Abstract Melanocytic lesion is defined as skin symptom due to proliferation of melanocytes. It may be considered benign, commonly diagnosed as melanocytic nevus (MN), or may also be malignant as malignant melanoma (MM). Publication of epidemiologic data about melanocytic lesion in Indonesia is limited. The aim of this study was to evaluate the epidemiologic findings of melanocytic lesion based on histopathology and clinical data. This descriptive study was done by collecting retrospective pigmented lesion from histopathology database at Department of Anatomical Pathology dr. Cipto Mangunkusumo National Hospital from 2014 - 2017. Retrieved data were analyzed descriptively for MN and MM include clinical diagnosis, age, sex, location, size and clinical working diagnosis. There were 121 cases of melanocytic lesions consisting of 87.6% MN. Females were more frequent for benign lesions. MN cases were mostly seen at the age below the fourth decade, while from 12 cases of MM found above fourth decade. MN was located mostly on the head and neck, while MM mostly in the lower extremities and soles. There were 75 lesions size and 4 lesions location were unknown data missing. MM is still considered rare. Completing clinical finding in the histopathology request form by surgeons will aid in defining better characteristic of melanocytic lesion in our population. Keyword: epidemiology, melanocytic lesion, nevus melanocytic, malignant melanoma. Studi Retrospektif Lesi Melanositik dalam Tiga Tahun di RS Tersier: Perbandingan Data Jinak dan Ganas Abstrak Lesi melanositik didefinisikan sebagai lesi kulit akibat proliferasi melanosit. Lesi melanositik dapat dianggap jinak, umumnya didiagnosis sebagai nevus melanositik (NM), atau merupakan ganas yaitu melanoma maligna (MM). Publikasi data epidemiologi tentang lesi melanositik di Indonesia masih terbatas. Tujuan dari penelitian ini adalah untuk melakukan evaluasi gambaran epidemiologis lesi melanositik berdasarkan data histopatologi dan klinis. Penelitian deskriptif ini dilakukan dengan mengumpulkan data retrospektif lesi berpigmen dari basis data histopatologi di Departemen Patologi Anatomi Rumah Sakit Nasional dr. Cipto Mangunkusumo dari tahun 2014 - 2017. Data dianalisis secara deskriptif untuk NM dan MM termasuk diagnosis kerja, usia, jenis kelamin, lokasi, ukuran, dan diagnosis klinis. Terdapat 121 kasus lesi melanositik yang terdiri atas 87,6% NM. Lesi jinak lebih banyak ditemukan pada wanita. Terdapat 75 dan 4 kasus dengan data ukuran lesi dan lokasi tidak tercantum. MM masih dianggap jarang. Kasus NM sebagian besar terlihat pada usia di bawah dekade keempat, sedangkan dari 12 kasus MM di atas dekade keempat. NM sebagian besar terletak di kepala dan leher, sedangkan MM ditemukan di ekstremitas bawah dan telapak kaki. Melengkapi temuan klinis dalam formulir permintaan histopatologi oleh dokter bedah akan membantu dalam menentukan karakteristik lesi melanositik lebih baik pada populasi ini. Kata kunci: epidemiologi, lesi melanositik, nevus melanositik, melanoma maligna

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Discordance in Diagnosis of Melanocytic Lesions and Its Impact on Clinical Management

Archives of Pathology & Laboratory Medicine ◽

10.5858/arpa.2020-0620-oa ◽

2021 ◽

Author(s):

Shira Ronen ◽

Rami N. Al-Rohil ◽

Elizabeth Keiser ◽

George Jour ◽

Priyadharsini Nagarajan ◽

...

Keyword(s):

Clinical Management ◽

Treatment Recommendation ◽

Comprehensive Cancer Center ◽

Cancer Center ◽

Melanocytic Lesion ◽

Dysplastic Nevus ◽

Melanoma In Situ ◽

Melanocytic Lesions ◽

Histopathologic Diagnosis

Context.— Accurate diagnosis of melanocytic lesions is fundamental for appropriate clinical management. Objective.— To evaluate the degree of discordance, if any, between histopathologic diagnoses of melanocytic lesions at referring institutions and at a tertiary referral cancer center and the potential impact of such discordance on clinical management. Design.— We retrospectively identified all patients referred to our comprehensive cancer center for evaluation of a melanocytic lesion from January 2010 to January 2011. For each patient, the histopathologic diagnosis from the referring institution was compared with the histopathologic diagnosis from a dermatopathologist at our center. Discordances were classified as major if they resulted in a change in clinical management and minor if they did not. Results.— A total of 1521 cases were included. The concordance rates were 72.2% (52 of 72) for dysplastic nevus, 75.0% (15 of 20) for all other types of nevi, 91.1% (143 of 157) for melanoma in situ, 96.1% (758 of 789) for invasive melanoma, and 99.6% (478 of 480) for metastatic melanoma. Major discordances were found in 20.2% of cases (307 of 1521), and minor discordances were found in 48.8% of cases (742 of 1521). Compared with the guideline-based treatment recommendation based on the referring-institution diagnosis, the guideline-based treatment recommendation based on the cancer center diagnosis was more extensive in 5.9% (89 of 1521) of patients and less extensive in 5.0% (76 of 1521) of patients. Conclusions.— Our findings underscore the importance of secondary histopathologic review of melanocytic lesions by expert dermatopathologists because significant changes in the diagnosis, tumor classification, and/or staging may be identified; thus, resulting in critical changes in recommendations for clinical management.

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Giant congenital melanocytic nevus

Anais Brasileiros de Dermatologia ◽

10.1590/abd1806-4841.20132233 ◽

2013 ◽

Vol 88 (6) ◽

pp. 863-878 ◽

Cited By ~ 44

Author(s):

Ana Carolina Leite Viana ◽

Bernardo Gontijo ◽

Flávia Vasques Bittencourt

Keyword(s):

Psychological Intervention ◽

Malignant Neoplasm ◽

Melanocytic Nevus ◽

Melanocytic Lesion ◽

Congenital Melanocytic Nevus ◽

Indication For Surgery ◽

Deep Layers ◽

The Central Nervous System ◽

Giant Congenital Melanocytic Nevus

Giant congenital melanocytic nevus is usually defined as a melanocytic lesion present at birth that will reach a diameter ≥ 20 cm in adulthood. Its incidence is estimated in <1:20,000 newborns. Despite its rarity, this lesion is important because it may associate with severe complications such as malignant melanoma, affect the central nervous system (neurocutaneous melanosis), and have major psychosocial impact on the patient and his family due to its unsightly appearance. Giant congenital melanocytic nevus generally presents as a brown lesion, with flat or mammilated surface, well-demarcated borders and hypertrichosis. Congenital melanocytic nevus is primarily a clinical diagnosis. However, congenital nevi are histologically distinguished from acquired nevi mainly by their larger size, the spread of the nevus cells to the deep layers of the skin and by their more varied architecture and morphology. Although giant congenital melanocytic nevus is recognized as a risk factor for the development of melanoma, the precise magnitude of this risk is still controversial. The estimated lifetime risk of developing melanoma varies from 5 to 10%. On account of these uncertainties and the size of the lesions, the management of giant congenital melanocytic nevus needs individualization. Treatment may include surgical and non-surgical procedures, psychological intervention and/or clinical follow-up, with special attention to changes in color, texture or on the surface of the lesion. The only absolute indication for surgery in giant congenital melanocytic nevus is the development of a malignant neoplasm on the lesion.

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