Late Onset Achromatic Melanoma Arising in a Giant Congenital Melanocytic Nevus

Georgi Tchernev; James W. Patterson; Ilko Bakardzhiev; Torello Lotti; Jacopo Lotti; Katlein FranÃ§a; Atanas Batashki; Uwe Wollina

doi:10.3889/oamjms.2017.077

Authors

Georgi Tchernev Department of Dermatology, Venereology and Dermatologic Surgery, Medical Institute of Ministry of Interior, and Onkoderma Polyclinic for Dermatology and Dermatologic Surgery, Sofia
James W. Patterson Departments of Pathology and Dermatology, University of Virginia Health System, Hospital Expansion, 3rd Floor, 1215 Lee Street, Charlottesville, VA
Ilko Bakardzhiev Medical College, Medical University of Varna,Varna 9000
Torello Lotti Department of Biotechnology, Delft University of Technology, 2628 BC, Delft
Jacopo Lotti Department of Nuclear, Subnuclear and Radiation Physics, University of Rome "G. Marconi", Rome
Katlein FranÃ§a Institute for Bioethics & Health Policy; Department of Dermatology & Cutaneous Surgery; Department of Psychiatry & Behavioral Sciences, University of Miami Miller School of Medicine - Miami, FL
Atanas Batashki Department of Special Surgery, Medical University of Plovdiv, bul. "Peshtersko shose" Nr 66, 4000, Plovdiv
Uwe Wollina Department of Dermatology and Allergology, Academic Teaching Hospital Dresden-Friedrichstadt, Friedrichstrasse 41, 01067, Dresden

DOI:

https://doi.org/10.3889/oamjms.2017.077

Keywords:

melanoma, congenital nevus, surgery, progression, outcome, prevention

Abstract

A 61-year-old woman, with a lifelong history of a giant congenital melanocytic nevus in the occipital region with secondary development of giant melanoma is presented. Surgical excision was performed, and the histopathological evaluation confirmed the diagnosis of Giant Malignant Melanoma (GMM) with a maximum tumour thickness of 16 mm. Nowadays, there is tremendous uncertainty regarding how giant congenital melanocytic nevi (GCMN) should be treated. The standard approach to patients with late onset giant congenital melanocytic nevi (GCMN is based on two main considerations: (1) obtain an acceptable cosmetic results with the purpose to decrease the psychosocial inconvenience to each patient, and (2) to attempt to minimise the risk of development of malignant transformation. Unfortunately complete surgical removal of the GCMN is usually difficult and very often impossible without subsequent functional or cosmetic mutilations.

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