Recent Data on the Risk of Malignancy in Congenital Melanocytic Nevi: The Continuing Debate on Treatment

Hernández, A.; Torrelo, A.

doi:10.1016/S1578-2190(08)70230-0

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Abstract

Congenital melanocytic nevi (CMN) have traditionally been considered a risk factor for the appearance of melanoma, but the true incidence of malignancy is unknown. Although various studies have attempted to quantify it, the results are highly variable and it is difficult to decide on the best therapeutic approach to take. Consequently, for some time the management of CMN has depended more on personal experience than on clear scientific evidence. The most recent studies performed in large patient series indicate that the risk of malignancy in CMN is much lower than expected and mainly affects large lesions involving the axial midline. In addition, it appears that a number of melanomas develop on the site of partially or completely excised lesions, or even away from the CMN itself, making the appropriateness of prophylactic surgery increasingly doubtful.

Key words:

congenital melanocytic nevus

melanoma

risk

Resumen

Los nevus melanocíticos congénitos (NMC) se han considerado tradicionalmente un factor de riesgo para la aparición de melanoma, pero se desconoce la verdadera incidencia de la malignización. Aunque numerosos trabajos han tratado de cuantificarla, los resultados son muy dispares y resulta difícil decidir qué actitud terapéutica es la más adecuada. Por este motivo, durante mucho tiempo el manejo de los NMC ha dependido más de la experiencia personal que de una auténtica evidencia científica. Los últimos estudios realizados en series amplias de pacientes reflejan que el riesgo de malignización de los NMC es mucho más bajo de lo que se creía, y afecta principalmente a lesiones de gran tamaño localizadas sobre el axis. Además, parece que un considerable número de melanomas se desarrolla sobre lesiones parcial o totalmente extirpadas, e incluso fuera del propio NMC, por lo que la necesidad de la cirugía profiláctica es cada vez más controvertida.

Palabras clave:

nevus melanocítico congénito

melanoma

riesgo

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References

[1.]

A.W. Kopf, R.S. Bart, P. Hennessey.

Congenital nevocytic nevi and malignant melanomas.

J Am Acad Dermatol, 1 (1979), pp. 123-130

Medline

[2.]

R. Ruiz-Maldonado.

Measuring congenital melanocytic nevi.

Pediatr Dermatol, 21 (2004), pp. 178-179

http://dx.doi.org/10.1111/j.0736-8046.2004.21222.x | Medline

[3.]

P. Berg, B. Lindelof.

Congenital melanocytic naevi and cutaneous melanoma.

Melanoma Res, 13 (2003), pp. 441-445

http://dx.doi.org/10.1097/01.cmr.0000056265.56735.3a | Medline

[4.]

J.K. Rivers, P.C. Frederiksen, C. Dibdin.

A prevalence survey of dermatoses in the Australian neonate.

J Am Acad Dermatol, 23 (1990), pp. 77-81

Medline

[5.]

M. DeDavid, S.J. Orlow, N. Provost, A.A. Marghoob, B.K. Rao, C.L. Huang, et al.

A study of large congenital melanocytic nevi and associated malignant melanomas: review of cases in the New York University Registry and the world literature.

J Am Acad Dermatol, 36 (1997), pp. 409-416

Medline

[6.]

B.J. Bett.

Large or multiple congenital melanocytic nevi: occurrence of cutaneous melanoma in 1,008 persons.

J Am Acad Dermatol, 52 (2005), pp. 793-797

http://dx.doi.org/10.1016/j.jaad.2005.02.024 | Medline

[7.]

B.J. Bett.

Large or multiple congenital melanocytic nevi: occurrence of neurocutaneous melanocytosis in 1,008 persons.

J Am Acad Dermatol, 54 (2006), pp. 767-777

http://dx.doi.org/10.1016/j.jaad.2005.10.040 | Medline

[8.]

A.A. Marghoob, S. Dusza, S. Oliveria, A.C. Halpern.

Number of satellite nevi as a correlate for neurocutaneous melanocytosis in patients with large congenital melanocytic nevi.

Arch Dermatol, 140 (2004), pp. 171-175

http://dx.doi.org/10.1001/archderm.140.2.171 | Medline

[9.]

V.S. Ka, S.W. Dusza, A.C. Halpern, A.A. Marghoob.

The association between large congenital melanocytic naevi and cutaneous melanoma: preliminary findings from an Internet-based registry of 379 patients.

Melanoma Res, 15 (2005), pp. 61-67

Medline

[10.]

E.K. Hale, J. Stein, L. Ben-Porat, K.S. Panageas, M.S. Eichenbaum, A.A. Marghoob, et al.

Association of melanoma and neurocutaneous melanocytosis with large congenital melanocytic naevi—results from the NYU-LCMN registry.

Br J Dermatol, 152 (2005), pp. 512-517

http://dx.doi.org/10.1111/j.1365-2133.2005.06316.x | Medline

[11.]

A.L. Agero, C. Benvenuto-Andrade, S.W. Dusza, A.C. Halpern, A.A. Marghoob.

Asymptomatic neurocutaneous melanocytosis in patients with large congenital melanocytic nevi: a study of cases from an Internet-based registry.

J Am Acad Dermatol, 53 (2005), pp. 959-965

http://dx.doi.org/10.1016/j.jaad.2005.07.046 | Medline

[12.]

S. Krengel, A. Hauschild, T. Schäfer.

Melanoma risk in congenital melanocytic naevi: a systematic review.

Br J Dermatol, 155 (2006), pp. 1-8

http://dx.doi.org/10.1111/j.1365-2133.2006.07218.x | Medline

[13.]

P.W. Greeley, G.A. Middleton, J.W. Curtin.

Incidence of malignancy in giant pigmented nevus.

Plast Reconstr Surg, 36 (1965), pp. 26-37

Medline

[14.]

Y.C. Chan, Y.C. Giam.

A retrospective cohort study of Southeast Asian patients with large congenital melanocytic nevi and the risk of melanoma development.

J Am Acad Dermatol, 54 (2006), pp. 778-782

http://dx.doi.org/10.1016/j.jaad.2006.02.063 | Medline

[15.]

A.J. Watt, S.V. Kotsis, K.C. Chung.

Risk of melanoma arising in large congenital melanocytic nevi: a systematic review.

Plast Reconstr Surg, 113 (2004), pp. 1968-1974

Medline

[16.]

S. Krengel.

Nevogenesis—new thoughts regarding a classical problem.

Am J Dermatopathol, 27 (2005), pp. 456-465

Medline

[17.]

H.S. Makkar, I.J. Frieden.

Neurocutaneous melanosis.

Semin Cutan Med Surg, 23 (2004), pp. 138-144

http://dx.doi.org/10.1016/j.sder.2004.01.007 | Medline

[18.]

V.A. Kinsler, S.E. Aylett, S.C. Coley, W.K. Chong, D.J. Atherton.

Central nervous system imaging and congenital melanocytic naevi.

Arch Dis Child, 84 (2001), pp. 152-155

Medline

[19.]

A.A. Marghoob, A.L. Agero, C. Benvenuto-Andrade, S.W. Dusza.

Large congenital melanocytic nevi, risk of cutaneous melanoma, and prophylactic surgery.

J Am Acad Dermatol, 54 (2006), pp. 868-870

http://dx.doi.org/10.1016/j.jaad.2006.03.008 | Medline

[20.]

R. Ruiz-Maldonado, L. Tamayo, A.M. Laterza, C. Duran.

Giant pigmented nevi: clinical, histopathologic and therapeutic considerations.

J Pediatr, 120 (1992), pp. 906-911

Medline

[21.]

J.D. Hopkins, A.W. Smith, I.T. Jackson.

Adjunctive treatment of congenital pigmented nevi with phenol chemical peel.

Plast Reconstr Surg, 105 (2000), pp. 1-11

Medline

[22.]

J.U. Ostertag, P.J. Quaedvlieg, F.E. Kerckhoffs, A.H. Vermeulen, M.J. Bertleff, A.W. Venema, et al.

Congenital naevi treated with erbium:YAG laser (Derma K) resurfacing in neonates: clinical results and review of the literature.

Br J Dermatol, 154 (2006), pp. 889-895

http://dx.doi.org/10.1111/j.1365-2133.2005.07106.x | Medline

[23.]

R. Rompel, M. Maser, J. Petres.

Dermabrasion of congenital nevocellular nevi: experience in 215 patients.

Dermatology, 194 (1997), pp. 261-267

Medline

[24.]

N.E. De Raeve, D.I. Roseeuw.

Curettage of giant congenital melanocytic nevi in neonates: a decade later.

Arch Dermatol, 138 (2002), pp. 943-947

Medline

[25.]

L.E. De Raeve, A. Claes, D.J. Ruiter, G.N. van Muijen, D. Roseeuw, L.C. van Kempen.

Distinct phenotypic changes between the superficial and deep component of giant congenital melanocytic naevi: a rationale for curettage.

Br J Dermatol, 154 (2006), pp. 485-492

http://dx.doi.org/10.1111/j.1365-2133.2005.07055.x | Medline

[26.]

M.H. Kanzler.

Management of large congenital melanocytic nevi: art versus science.

J Am Acad Dermatol, 54 (2006), pp. 874-876

http://dx.doi.org/10.1016/j.jaad.2006.03.005 | Medline

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