Article information
Abstract
Congenital melanocytic nevi are very common lesions that nevertheless pose many controversial questions. A systematic review of the literature suggests that the risk of developing melanoma on giant congenital melanocytic nevi (GCMN) is lower than previously thought given that, in the most recent series of GCMN, only 2% of patients developed melanoma and most did so before the age of 5 years. Therefore, prophylactic surgery should be considered on an individual basis according to the degree of clinical suspicion of melanoma and the esthetic and functional consequences. In extensive reviews of series of biopsies of melanoma, small congenital melanocytic nevi have been associated with 7% to 8% of cases. Many authors believe that these might represent a significant risk of malignant conversion from 10 years onwards and so recommend regular control visits during infancy and prophylactic exeresis in puberty.
Key words:
congenital melanocytic nevus
neurocutaneous melanosis
melanoma
Resumen
Los nevus melanocíticos congénitos son lesiones muy frecuentes, pero que todavía plantean muchas cuestiones que son motivo de controversia. Una revisión sistématica de la literatura sugiere que el riesgo de desarrollar melanoma sobre nevus melanocíticos congénitos gigantes (NMCG) es inferior al que se postuló históricamente. En las series de NMCG más recientes sólo un 2% de pacientes desarrolló un melanoma y la mayoría lo hizo antes de los 5 años de edad. Por tanto, su tratamiento quirúrgico profiláctico debe ser individualizado en función de la sospecha clínica de melanoma y de las consecuencias estéticas y funcionales.
En revisiones amplias de biopsias de melanoma se han encontrado NMC pequeños asociados en un 7-8% de los casos. Muchos autores consideran que podrían tener un riesgo de malignización significativo a partir de la segunda década de vida, por lo que recomiendan la vigilancia periódica durante la infancia y la exéresis profiláctica en la pubertad.
Palabras clave:
nevus melanocítico congénito
melanosis neurocutánea
melanoma
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