Slutsky Jordan B, Barr Jeffrey M, Femia Alisa N, Marghoob Ashfaq A
Department of Dermatology, SUNY Stony Brook, Stony Brook, NY, USA.
Semin Cutan Med Surg. 2010 Jun;29(2):79-84. doi: 10.1016/j.sder.2010.04.007.
Large congenital melanocytic nevi (LCMN) in neonates can cause considerable concern for parents, family members, and physicians. A detailed understanding of the medical risks, including cutaneous melanoma (CM), extracutaneous melanoma (ECM), and neurocutaneous melanocytosis (NCM), as well as the psychological stress that these lesions can cause in patients, will guide informed management decisions as well as provide comfort to parents. Current data indicate that LCMN greater than 20 cm, and more likely greater than 40 to 60 cm, are the lesions at greatest risk for complications such as CM, ECM, and NCM. Additionally, lesions on the trunk are at greater risk for developing CM, and LCMN in association with numerous satellite nevi are at greatest risk for NCM. Individualized management plans, including clinical observation, magnetic resonance imaging (MRI), and possibly surgery should be based on the risk versus benefit ratio, taking into account the size of the LCMN, its location, the number of satellite nevi, symptoms, and numerous other factors which will be reviewed. This paper will provide a detailed analysis of the risks associated with LCMN, as well as a discussion regarding management and treatment options.
新生儿的巨大先天性黑素细胞痣（LCMN）会引起父母、家庭成员和医生的极大关注。详细了解包括皮肤黑色素瘤（CM）、皮肤外黑色素瘤（ECM）和神经皮肤黑素沉着症（NCM）在内的医学风险，以及这些病变可能给患者带来的心理压力，将指导明智的管理决策，并让父母安心。目前的数据表明，大于20 cm，更可能大于40至60 cm的LCMN是发生CM、ECM和NCM等并发症风险最高的病变。此外，躯干上的病变发生CM的风险更高，而伴有大量卫星痣的LCMN发生NCM的风险最高。个体化的管理计划，包括临床观察、磁共振成像（MRI），以及可能的手术，应基于风险与获益比，同时考虑LCMN的大小、位置、卫星痣数量、症状以及众多其他将被审视的因素。本文将对与LCMN相关的风险进行详细分析，并讨论管理和治疗选择。
