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Malignant Melanoma Arising at the Site of a Previously Excised Giant Congenital Melanocytic Nevus

Carrie C. Coughlin, MD1; M. Laurin Council, MD1; Alejandro A. Gru, MD2; Ryan C. Fields, MD3; Susan J. Bayliss, MD1
[+] Author Affiliations
1Division of Dermatology, Department of Medicine, Washington University School of Medicine, St Louis, Missouri
2Department of Pathology, Washington University School of Medicine, St Louis, Missouri
3Department Surgery, Washington University School of Medicine, St Louis, Missouri
JAMA Dermatol. 2014;150(1):100-101. doi:10.1001/jamadermatol.2013.5775.
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Patients with giant congenital nevi are at increased risk for malignant melanoma. Most reported cases involve development of melanoma during childhood, usually before age 6 years.13 Herein, we report a case of a man with a giant congenital nevus and satellite nevi who underwent multiple excisions and grafting procedures as a child and developed malignant melanoma more than 30 years later.

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Figure 1.
Clinical Images

A, Tender nodule (circled) on the upper right posterior thigh in a graft site. B, Upper right posterior thigh after wide local excision (the 0-50 scale represents millimeters).

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Figure 2.
Histopathologic Findings

A. Malignant melanoma with epithelioid cells and nevoid features (left) immediately adjacent to a nevus with neurotization (right) (hematoxylin-eosin, original magnification ×400). B, Lymph node with metastatic melanoma (hematoxylin-eosin, original magnification ×200). C, Lymphovascular space invasion by the tumor cells (hematoxylin-eosin, original magnification ×400).

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