Giant congenital melanocytic nevi.

LEARNING OBJECTIVES

After studying this article, the participant should be able to: 1. Define what is meant by a giant congenital melanocytic nevus and understand its histologic properties. 2. Know the natural history and potential complications associated with a giant congenital melanocytic nevus. 3. Outline the nonsurgical and surgical options available to treat a giant congenital melanocytic nevus.

BACKGROUND

Giant congenital melanocytic nevi are rare lesions with a propensity to degenerate to malignant melanoma. Certain lesions also may be associated with neurocutaneous melanosis, which can on occasion be symptomatic. Appropriate investigations include a screening magnetic resonance imaging scan, neurologic evaluation, and serial clinical observations for the development of cutaneous melanoma. A variety of nonsurgical and surgical options are possible for the treatment of giant congenital melanocytic nevi.

METHODS

A MEDLINE search was performed to gather all pertinent articles from 1955 to 2005.

RESULTS

Giant congenital melanocytic nevi are a difficult diagnostic and reconstructive challenge, requiring careful preoperative evaluation, staged surgical excision, and lifelong patient monitoring and follow-up. With proper treatment, patients can expect a decreased risk of melanoma, with the possibility for early detection and cure of melanoma, amelioration of symptoms, improved aesthetics and psychosocial sequelae, and maintenance of function.

CONCLUSION

The plastic surgeon treating these challenging lesions must have a solid working knowledge of the disease's histology, its natural history and complications, and the options for treatment.