López Gutiérrez J C, García Palacios M, Díaz Mercedes, Soto C, Ros Z
Servicio de Cirugía Pediátrica, Sección de Cirugía Plástica, Hospital Universitario La Paz, Madrid.
Cir Pediatr. 2010 Jul;23(3):165-9.
Most of specialists involved in giant congenital nevi (GCN) care, agree that the risk of melanoma is probably not significant enough to warrant the prophylactic removal of all those lesions. However, many patients benefit from very early surgical procedures.
In the last 15 years 41 children undergwent surgical removal of their large or giant melanocityc lesions in the first year of life at our institution. Indications for such an early excision were as follows: painful ulceration or bleeding, alarming dermatoscopic changes, location in the scalp being removable with primary closure, concomitant surgical procedures, multiple expected interventions and severe parental psychosocial distress.
All patients had a good cosmetic result. All nevus in the scalp between 3 and 5 cms were removed with a primary closure in order to avoid future need of scalp expansion. Familial psychological distress improved significantly and disturbances related to scholar activities were not noticed.
Despite the lack of international consensus regarding the appropriate timing for large or giant congenital nevi excision, a selection of patients and their families can benefit from early surgical removal.
大多数参与巨大先天性痣（GCN）治疗的专家都认为，黑色素瘤的风险可能不足以显著到需要预防性切除所有这些病变。然而，许多患者从非常早期的手术中受益。
在过去15年里，41名儿童在我院出生后第一年接受了大或巨大黑素细胞性病变的手术切除。早期切除的指征如下：疼痛性溃疡或出血、令人担忧的皮肤镜改变、位于头皮且可一期缝合切除、同期手术、多次预期干预以及严重的父母心理社会困扰。
所有患者都取得了良好的美容效果。头皮上3至5厘米的所有痣均一期缝合切除，以避免未来头皮扩张的需要。家族心理困扰显著改善，未发现与学业活动相关的干扰。
尽管对于大或巨大先天性痣切除的合适时机缺乏国际共识，但部分患者及其家属可从早期手术切除中受益。
