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Nathan S, Smetona J, Naran S, Bauer BS. Congenital Melanocytic Nevi. Clin Plast Surg 2025; 52:259-269. [PMID: 39986887 DOI: 10.1016/j.cps.2024.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/24/2025]
Abstract
Congenital melanocytic nevi are benign neoplasms, which present early in life at various anatomic locations with a variety of clinical presentations. When evaluating large or giant nevi, it's important to use a multidisciplinary team and rule out comorbid conditions, such as neurocutaneous melanosis. Surgical interventions include direct excision, serial excision, and tissue expansion. For more complex lesions, tissue expansion is a versatile and effective option for many areas of the body. Most large or giant lesions require serial excision and long-term follow-up.
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Affiliation(s)
- Shelby Nathan
- Division of Plastic and Reconstructive Surgery, University of Chicago, Chicago, IL, USA.
| | - John Smetona
- Department of Pediatric Plastic Surgery, Advocate Children's Hospital, Chicago, IL, USA
| | - Sanjay Naran
- Department of Pediatric Plastic Surgery, Advocate Children's Hospital, Chicago, IL, USA; Section of Plastic and Reconstructive Surgery, University of Chicago Medicine & Biological Sciences; Department of Plastic Surgery, University of Pittsburgh School of Medicine
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2
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Goel A, Goel A. Optimal timing for plastic surgical procedures for common congenital anomalies: A review. World J Clin Pediatr 2024; 13:90583. [PMID: 38947997 PMCID: PMC11212758 DOI: 10.5409/wjcp.v13.i2.90583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Revised: 04/04/2024] [Accepted: 04/11/2024] [Indexed: 06/07/2024] Open
Abstract
Apart from listening to the cry of a healthy newborn, it is the declaration by the attending paediatrician in the labour room that the child is normal which brings utmost joy to parents. The global incidence of children born with congenital anomalies has been reported to be 3%-6% with more than 90% of these occurring in low- and middle-income group countries. The exact percentages/total numbers of children requiring surgical treatment cannot be estimated for several reasons. These children are operated under several surgical disciplines, viz, paediatric-, plastic reconstructive, neuro-, cardiothoracic-, orthopaedic surgery etc. These conditions may be life-threatening, e.g., trachea-oesophageal fistula, critical pulmonary stenosis, etc. and require immediate surgical intervention. Some, e.g., hydrocephalus, may need intervention as soon as the patient is fit for surgery. Some, e.g., patent ductus arteriosus need 'wait and watch' policy up to a certain age in the hope of spontaneous recovery. Another extremely important category is that of patients where the operative intervention is done based on their age. Almost all the congenital anomalies coming under care of a plastic surgeon are operated as elective surgery (many as multiple stages of correction) at appropriate ages. There are advantages and disadvantages of intervention at different ages. In this article, we present a review of optimal timings, along with reasoning, for surgery of many of the common congenital anomalies which are treated by plastic surgeons. Obstetricians, paediatricians and general practitioners/family physicians, who most often are the first ones to come across such children, must know to guide the parents appropriately and convincingly impress upon the them as to why their child should not be operated immediately and also the consequences of too soon or too late.
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Affiliation(s)
| | - Arun Goel
- Department of Plastic Surgery, Lok Nayak Hospital and Associated Maulana Azad Medical College, New Delhi 110002, India
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3
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Namgoong S, Lee KI, Han SK, Jeong SH, Dhong ES. Staged Excision Technique to Reduce Scar Length. J Plast Reconstr Aesthet Surg 2022; 75:2775-2783. [PMID: 35379584 DOI: 10.1016/j.bjps.2022.02.043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Revised: 01/11/2022] [Accepted: 02/15/2022] [Indexed: 11/29/2022]
Abstract
Patients and surgeons are often disappointed with the scar length after conventional staged excision of large disfiguring skin lesions. We have developed an alternative approach to facilitate scar length reduction. We aimed to report the efficacy of our staged excision method, which includes a hexagonal-pattern excision, wide undermining, and purse-string suture. Sixty-five patients, each with one lesion, were included in the current study. The lesion length and width were recorded, and the scar area was calculated at each stage. The final scar length after performing the altered staged excision method was compared with that obtained after the conventional staged excision method, which was calculated using a theoretical scar model. Patient satisfaction was also evaluated. The mean longest axis length was 9.41 ± 3.83 cm preoperatively, 9.50 ± 3.92 cm after the first stage postoperatively, and 10.19 ± 3.98 cm after the final stage. The mean lesion width was 6.50 ± 3.48 cm preoperatively, 3.60 ± 1.77 cm after the first stage postoperatively, and 0.42 ± 0.31 cm after the final stage. The final scar length obtained using the altered procedure was much shorter than what would be obtained using conventional staged excision. The patient satisfaction score was 8.8 ± 1.1 out of a possible 10.0 rating. Staged excision with a hexagonal-pattern excision, wide undermining, and purse-string closure may improve aesthetic results.
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Affiliation(s)
- Sik Namgoong
- Department of Plastic Surgery, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | - Kyu-Il Lee
- Department of Plastic Surgery, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | - Seung-Kyu Han
- Department of Plastic Surgery, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea.
| | - Seong-Ho Jeong
- Department of Plastic Surgery, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | - Eun-Sang Dhong
- Department of Plastic Surgery, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea
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Wu M, Yu Q, Gao B, Sheng L, Li Q, Xie F. A large-scale collection of giant congenital melanocytic nevi: Clinical and histopathological characteristics. Exp Ther Med 2019; 19:313-318. [PMID: 31853305 DOI: 10.3892/etm.2019.8198] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2017] [Accepted: 01/03/2018] [Indexed: 11/06/2022] Open
Abstract
Giant congenital melanocytic nevi (GCMN) place a heavy psychological burden on patients due to their poor cosmetic appearance. The histopathological characteristics of GCMN have remained largely elusive. The present study investigated the histopathological characteristics of GCMN in association with their clinical appearance. A total of 98 patients diagnosed with GCMN were included in the present study and their clinical features were collected from their records. Lesion specimens were obtained and stained for histopathological analysis. Regarding the microscopic appearance of GCMN, nevi cells in the whole dermis exhibited different patterns than those in healthy tissues. Most GCMN cases featured a sub-epidermal non-involvement zone, which implies an early occurrence in embryo development. Darker nevi exhibited a higher density of infiltrated nevi cells and more pigment deposition; this appears to induce a poor skin texture. Chemical peeling and laser therapy only partly removes pigment particles and nevi cells in the upper portion of the dermis. The clinical features of GCMN are associated with the histopathological characteristics, and non-surgical therapy cannot remove the nevus cells in the deep dermis.
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Affiliation(s)
- Min Wu
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University, School of Medicine, Shanghai 200011, P.R. China
| | - Qingxiong Yu
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University, School of Medicine, Shanghai 200011, P.R. China
| | - Bowen Gao
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University, School of Medicine, Shanghai 200011, P.R. China
| | - Lingling Sheng
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University, School of Medicine, Shanghai 200011, P.R. China
| | - Qingfeng Li
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University, School of Medicine, Shanghai 200011, P.R. China
| | - Feng Xie
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University, School of Medicine, Shanghai 200011, P.R. China
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Agarwal A, Dhameja N, Ghosh Kar A. Giant congenital melanocytic nevus associated with lipoma in an Indian man. BMJ Case Rep 2019; 12:12/7/e228688. [PMID: 31272992 DOI: 10.1136/bcr-2018-228688] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Congenital melanocytic nevus is a inborn melanocytic proliferation either present since birth or soon afterward and shows characteristic histopathological features comprising proliferation of benign melanocytes and extension of nevus cells into the deep reticular dermis and subcutis. We report the case of a 35-year-old male patient who presented with a progressively enlarging soft tissue mass in bilateral flank region. High-resolution ultrasound imaging showed multiple lipomatous masses within the soft tissues on the either flank region. Subsequent excision of the soft tissue mass showed a well-circumscribed lipomatous lesion with diffuse infiltration by benign appearing melanocytes within the fat lobules established by immunohistochemistry, which was positive for HMB45 and S100. This case serves to illustrate the initial diagnostic challenge in a male patient as well as the plasticity of the neural crest cells.
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Affiliation(s)
- Apoorva Agarwal
- Pathology, King George's Medical University, Lucknow, UP, India
| | - Neeraj Dhameja
- Pathology, Banaras Hindu University Institute of Medical Sciences, Varanasi, UP, India
| | - Amrita Ghosh Kar
- Pathology, Banaras Hindu University Institute of Medical Sciences, Varanasi, UP, India
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Malignant Melanoma in Association With a Thymic Nevus in a Patient With a Giant Congenital Nevus. Am J Dermatopathol 2017; 39:538-541. [DOI: 10.1097/dad.0000000000000817] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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7
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Staged Excision: Tips and Pitfalls. CURRENT DERMATOLOGY REPORTS 2016. [DOI: 10.1007/s13671-016-0153-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Giant congenital melanocytic nevus: report from 30 years of experience in a single department. Ann Plast Surg 2015; 74:223-9. [PMID: 23903082 DOI: 10.1097/sap.0b013e3182920c3d] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Giant congenital melanocytic nevi (GCMN) occur in 1:20,000 livebirths and are associated with increased risk of malignant transformation. The treatment of GCMN from 1981 to 2010 in a tertiary referral center was reviewed evaluating the modalities used, cosmetic results, associated complications, and malignant transformation. Of 35 patients, 25 underwent surgery. Curettage was most frequently used (64%) followed by excision and tissue expansion (20%). Six percent of the patients treated with curettage, and 78% of the patients who received excision surgery required more than 1 planned procedure, and 25% versus 44% required unplanned additional surgery, respectively. Complications were noted in 25% and 67% of the patients, respectively. Cosmetic result was satisfying in 76% of patients without difference between the groups. No malignant transformation was found during a mean follow-up of 11 years. Curettage is a gentle alternative to excision with a lower complication rate and good cosmetic outcome.
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A deep penetrating facial congenital melanocytic tumor with bone involvement and ipsilateral eye blindness. Am J Dermatopathol 2015; 37:e5-e11. [PMID: 25222197 DOI: 10.1097/dad.0000000000000048] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Bone involvement has been described in tumors with melanocytic differentiation such as melanotic neuroectodermal tumor of infancy, and very rarely in cellular blue nevi and neurocristic cutaneous hamartoma. We present an unusual case of facial congenital melanocytic tumor that involved the underlying bones and maxillary sinus and led to unilateral blindness. A newborn with a large red bluish patch with peripheral brown and black macules overlying marked swelling on the left side of his face was presented. The tumor was shown by magnetic resonance imaging, scintigraphy, and histopathology to invade the underlying bones and maxillary sinus and to compress the left eyeball resulting in blindness. Histopathology, immunohistochemistry, morphometric computerized microscopy, molecular genetic mutation analysis, and fluorescent in situ hybridization studies were more congruent with a melanocytic nevus. An 8.5-year follow-up was uneventful, with spontaneous partial shrinkage of the tumor.
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10
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Sagittal synostosis after excision of congenital pigmented nevus of the scalp: a possible complication of the tissue expansion technique. EUROPEAN JOURNAL OF PLASTIC SURGERY 2015. [DOI: 10.1007/s00238-015-1099-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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11
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van Geel N, Van Poucke L, Van de Maele B, Speeckaert R. Relevance of congenital melanocytic naevi in vitiligo. Br J Dermatol 2015; 172:1052-7. [PMID: 25292332 DOI: 10.1111/bjd.13444] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/25/2014] [Indexed: 11/28/2022]
Abstract
BACKGROUND Some case reports concerning the concomitant presence of congenital melanocytic naevi (CMN), halo naevi and vitiligo have been published. However, their possible link has never been investigated in a large patient population. OBJECTIVES To evaluate the relevance of CMN in patients with vitiligo with respect to the presence of halo naevi and some general clinical variables such as age of onset, Koebner phenomenon and body surface area (BSA) involvement. METHODS In total, 1004 patients with vitiligo (nonsegmental) and 291 control patients were included in this observational study. CMN were scored in size, location and halo formation, and classified into clinical convincing or possible lesions. RESULTS Convincing CMN were present in 3·3% of the patient population and in 1·0% of the control population. The presence of halo naevi was significantly higher (P = 0·01) and age of onset of vitiligo was significantly lower (P < 0·01) in the presence of CMN. Halo formation around the CMN, as observed in 30·3% of cases, was associated with a higher diameter of the CMN. Patients with congenital naevi had a particular predisposition to having lesions on joints/acral areas and reported more often signs of Koebner phenomenon (P = 0·01). No clear difference in disease activity, BSA involvement, associated autoimmune diseases or treatment response was observed in patients with vitiligo with or without congenital naevi. CONCLUSIONS This study provides clinical evidence that CMN may influence the age of onset of vitiligo and trigger the development of halo naevi in patients with vitiligo.
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Affiliation(s)
- N van Geel
- Department of Dermatology, Ghent University Hospital, De Pintelaan 185,, 9000, Ghent, Belgium
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Viana ACL, Gontijo B, Bittencourt FV. Giant congenital melanocytic nevus. An Bras Dermatol 2014; 88:863-78. [PMID: 24474093 PMCID: PMC3900335 DOI: 10.1590/abd1806-4841.20132233] [Citation(s) in RCA: 75] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2012] [Accepted: 12/20/2012] [Indexed: 11/29/2022] Open
Abstract
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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Affiliation(s)
- Ana Carolina Leite Viana
- Minas Gerais Federal University, Teaching Hospital, dermatology service, Belo HorizonteMG, Brazil, MD, MSc - Voluntary dermatologist at the dermatology service at Minas Gerais Federal University Teaching Hospital (UFMG) - Belo Horizonte (MG), Brazil
| | - Bernardo Gontijo
- Minas Gerais Federal University, Medical School, Belo HorizonteMG, Brazil, MD, PhD - Associate Professor of dermatology at Minas Gerais Federal University Medical School (UFMG) - Belo Horizonte (MG), Brazil
| | - Flávia Vasques Bittencourt
- Minas Gerais Federal University, Medical School, Belo HorizonteMG, Brazil, MD, PhD - Adjunct Professor of dermatology at Minas Gerais Federal University Medical School (UFMG) - Belo Horizonte (MG), Brazil
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Drukker L, Margulis A, Chaouat M, Levitzki R, Maiorenko E, Ben Bassat H. Changes of PI3K/AKT/BCL2 signaling proteins in congenital Giant Nevi: melanocytes contribute to their increased survival and integrity. J Recept Signal Transduct Res 2013; 33:359-66. [PMID: 24069951 DOI: 10.3109/10799893.2013.838785] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Congenital Giant Nevi (CGN) are rare melanocytic lesions with the potential to regress into malignant melanoma. Simultaneous up-regulation and cooperative interactions of signaling pathways are crucial events in the pathogenesis of melanocytes. Our study aimed to identify changes in the expression and activation of proteins controlling survival and/or apoptosis of the key signaling pathways PI3K/AKT/BCL2 and Wnt/β-catenin of CGN melanocytes. We applied a model of cultured melanocytes from paired CGN and normal appearing skin, and Western blot (WB) analyzed the expression and activation profile of survival and anti-apoptotic proteins of these signaling pathways, growth pattern, cell cycle and apoptosis. WB analysis demonstrated a significant higher expression level of activated AKT and of BCL2 proteins in the CGN melanocytes compared with paired melanocytes from normal appearing skin. A relative increase in the level of GSK3 and FOXO1 proteins, down stream targets of AKT, as well as of pβ-catenin was also detected in the CGN melanocytes compared with the controls. These changes were not affected by growth of the CGN melanocytes in reduced serum (starvation). Both cell populations shared a similar growth pattern, with no significant differences in the proportion of apoptotic cells and in cell cycle fractions. These data demonstrate for the first time, changes in signaling proteins of cultured CGN melanocytes. Further, suggesting that the changes in AKT/BCL2 signaling molecules might mediate growth and anti-apoptosis processes at least in part, thus increasing the survival potential of CGN melanocytes and maintaining their integrity.
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Affiliation(s)
- Lior Drukker
- Israel National Skin Bank-Laboratory of Experimental Surgery and
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Silveira MLD, Ferreira FR, Alvarenga ML, Mandelbaum SH. Association of giant congenital melanocytic nevus, halo nevus and vitiligo in a 75-year-old patient. An Bras Dermatol 2012; 87:288-91. [DOI: 10.1590/s0365-05962012000200015] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2011] [Accepted: 06/20/2011] [Indexed: 11/21/2022] Open
Abstract
A giant congenital melanocytic nevus represents a rare condition. The halo phenomenon may be seen in congenital or acquired melanocytic nevi. In the literature, association of halo nevus and giant congenital melanocytic nevus is rare and the association of both with vitiligo even more rare. A 75-yearold woman at first consultation complained of a hyperchromic bluish-brown hairy macula on the lower back, buttocks and thighs present since birth and an achromic halo of onset three years ago. The histological features were consistent with congenital melanocytic nevus and halo nevus, respectively. After two years the patient developed achromic areas in normal skin, histologically consistent with vitiligo. The authors emphasize the rarity of this triple combination, the patient's age and the absence of malignant degeneration to date.
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15
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Fife DJ, Alam M. Alternative techniques for reduction of scar length during staged excision. J Am Acad Dermatol 2011; 65:811-818. [PMID: 21840623 DOI: 10.1016/j.jaad.2011.06.016] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2010] [Revised: 04/27/2011] [Accepted: 06/06/2011] [Indexed: 11/27/2022]
Abstract
BACKGROUND Staged excision is routinely used to remove disfiguring or premalignant cutaneous lesions with reduced functional loss or patient debilitation. Conventional staged excision results in a final scar length that is significantly shorter than the scar associated with a traditional elliptical excision with a 3:1 length to width ratio. OBJECTIVE We describe alternatives to the conventional staged excision that enable even further reduction in final scar length. METHODS Geometric simulations were performed to identify variants of the conventional staged excision that shortened the long axis of the final scar without increasing the number of stages required for complete removal. RESULTS At least 3 variants of the conventional staged excision enable shortening of the final scar: (1) the "doughnut" method, in which a ring (torus) of tissue is removed from within the middle of the lesion, and the outer rim is circumferentially sutured to the central core; (2) central excision and purse-string closure, in which the center of the lesion is removed, a large-caliber suture is passed along the outside rim to facilitate cinching, and reinforcing sutures are used to further reduce the wound length; and (3) the compressed design method, in which transposed ellipses or half-ellipses are carved within the lesion. These central defects are then sutured, with resulting abbreviation of the scar. LIMITATIONS The proposed techniques have been tested on a small cohort and require further clinical validation. CONCLUSION Staged excision can be modified for reduced final scar length. At least 3 different techniques can achieve this objective.
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Affiliation(s)
- Douglas J Fife
- Surgical Dermatology and Laser Center, Las Vegas, Nevada; Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois.
| | - Murad Alam
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois; Department of Otolaryngology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois; Department of Surgery, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
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16
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Raina UK, Chaudhuri Z. Ectopic lacrimal glandular tissue in a neonate with giant congenital melanocytic nevi and cutis verticis gyrata. J Pediatr Ophthalmol Strabismus 2010; 47 Online:e1-4. [PMID: 21047052 DOI: 10.3928/01913913-20100324-08] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2007] [Accepted: 06/16/2008] [Indexed: 11/20/2022]
Abstract
This report describes an unusual case of a neonate with giant congenital melanocytic nevi covering more than 80% of the body surface area, with cutis verticis gyrata and abnormal lacrimal glandular tissue rests in the epibulbar area. The patient's mother had pigmented lesions in the periorbital region and sclera.
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Affiliation(s)
- Usha K Raina
- Guru Nanak Eye Centre, Maulana Azad Medical College, New Delhi, India
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17
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Li HK, Shields CL, Mashayekhi A, Randolph JD, Bailey T, Burnbaum J, Shields JA. Giant Choroidal Nevus. Ophthalmology 2010; 117:324-33. [PMID: 19969359 DOI: 10.1016/j.ophtha.2009.07.006] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2009] [Revised: 07/01/2009] [Accepted: 07/02/2009] [Indexed: 02/03/2023] Open
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18
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Beier JP, Schnabl S, Arkudas A, Schlabrakowski A, Bauerschmitz J, Horch RE. [Giant congenital naevus : Indications and techniques for surgical treatment]. Chirurg 2009; 81:127-33. [PMID: 20013252 DOI: 10.1007/s00104-009-1815-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
According to current knowledge the term giant congenital naevus is generally applied to skin alterations which consist of naevus cells, that are already conspicuous at birth and reach a diameter of at least 20 cm or more in adulthood. Surgical removal of such alterations is fundamentally indicated because there is high potential for degeneration. The surgical challenge is the functional and aesthetic reconstruction after removal. This article presents the incidence, natural course and pathology of such giant congenital naevus alterations. The advantages and disadvantages of various reconstruction procedures are presented together with an algorithm for management of these potentially malignant alterations.
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Affiliation(s)
- J P Beier
- Plastisch- und Handchirurgische Klinik, Universitätsklinikum Erlangen, Deutschland.
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19
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Hu XG, Ma HH, Zhao YY, Yang QH. Comprehensive surgical approaches to management of various facial nevi. ACTA ACUST UNITED AC 2009; 24:127-9. [PMID: 19618612 DOI: 10.1016/s1001-9294(09)60075-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To investigate the effects of the flexible surgical approaches on therapeutic and cosmetic outcomes of facial nevi. METHODS From August 2002 to January 2008, 16 cases with facial nevi had been treated in our wards with the selected approaches. Surgical approaches including serial excision or one-time radical excision, free skin graft, and expanded flap were adopted in accordance with the individual size and location of the facial nevi. RESULTS All cases experienced complete excision and had satisfactory cosmetic appearance in the end. CONCLUSION The flexible surgical measures help to minimize the risk of malignant transformation and achieve good cosmetic results.
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Affiliation(s)
- Xiao-gen Hu
- Department of Plastic Surgery, China-Japan Friendship Hospital, Chinese Health Ministry, Beijing 100029, China.
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20
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Hashmi GS, Ahmed SS, Khan S. Congenital giant melanocytic nevi. Rare Tumors 2009; 1:e9. [PMID: 21139903 PMCID: PMC2994429 DOI: 10.4081/rt.2009.e9] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2009] [Accepted: 06/29/2009] [Indexed: 11/25/2022] Open
Abstract
Nevi are common skin tumors caused by abnormal overgrowth of cells from the epidermal and dermal layers of the skin. Most nevi are benign, but some pre-cancerous nevi must be monitored or removed. The giant congenital nevus is greater than 10 cm in size, pigmented and often hairy. Between 4% and 6% of these lesions will develop into a malignant melanoma. Since approximately 50% of the melanoma develop by the age of two, and 80% by the age of seven, early removal is recommended. The objective of this paper is to present a unique case of giant nevi and their surgical management.
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Affiliation(s)
- Ghulam S Hashmi
- Dept. of Oral & Maxillofacial Surgery, Faculty of Medicine, Aligarh Muslim University, Aligarh, India
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Abstract
Background Malignant mela-noma is a rare neoplasm in the pediatric population, but its incidence has risen in recent years. Methods The literature was reviewed to define the current clinical and pathologic features of pediatric melanoma, highlighting the similarities and differences between adult and pediatric melanoma. Results Distinctive features of this disease, including frequency and type of genetic abnormalities, predisposing conditions, clinical presentation, stage at diagnosis, prognostic features, and frequency of sentinel lymph node positivity are emphasized. Treatment strategies, extrapolated from adult mela-noma trials, are also discussed. Conclusions Despite the differences between pediatric and adult melanoma, survival rates are similar and are improving in both populations. Further studies will help delineate the pathogenesis of both adult and pediatric melanoma, with the goal of contributing to early detection and improved survival.
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Affiliation(s)
- Omie Mills
- University of South Florida College of Medicine, Department of Pathology and Cell Biology, and the H. Lee Moffitt Cancer Center & Research Institute, Tampa, Florida
| | - Jane L. Messina
- University of South Florida College of Medicine, Department of Pathology and Cell Biology, and the H. Lee Moffitt Cancer Center & Research Institute, Tampa, Florida
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Gönül M, Soylu S, Gül Ü, Aslan E, Ünal T, Ergül G. Giant congenital melanocytic naevus associated with Dandy-Walker malformation, lipomatosis and hemihypertrophy of the leg. Clin Exp Dermatol 2009; 34:e106-9. [PMID: 19438567 DOI: 10.1111/j.1365-2230.2008.03191.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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