Jeong Dae Kyun, Bae Yong Chan, Lee So Jeong, Kim Hoon Soo, Choi Young Jin
Department of Plastic and Reconstructive Surgery, Pusan National University School of Medicine, Busan, Korea.
Biomedical Research Institute, Pusan National University Hospital, Busan, Korea.
Arch Craniofac Surg. 2019 Aug;20(4):260-264. doi: 10.7181/acfs.2019.00283. Epub 2019 Aug 20.
Dysplastic nevus is common and affects about 10% of the northern European-descendent population. Studies over the past several decades have identified dysplastic nevi as a risk factor for malignant melanoma. Furthermore, in rare cases, they confirmed that dysplastic nevi have progressed to melanoma. Cases in which dysplastic nevi progressed to malignant melanoma in multiple studies are not uncommon. A 35-year-old woman presented with the major symptom of multiple itchy brown nodules (2.0 cm× 1.3 cm) in the left cheek that had first appeared 20 years earlier. Complete excision was performed at the first visit; subsequent biopsy confirmed that they were dysplastic nevi. They recurred three times over 3 years at the same site, all of which were histologically diagnosed as dysplastic nevi. Five years after the final excision, a brownish nodule developed in the left cheek, with others at the left temporal region, right retroauricular region, and left shoulder at the same time. These lesions were histologically diagnosed as malignant melanoma. We experienced a case of malignant melanoma that occurred at the same site after three recurrences of dysplastic nevi. Although rare, the possibility of malignant melanoma should be considered in follow-ups in cases involving repeatedly recurrent dysplastic nevi.
发育异常痣很常见,约影响10%的北欧后裔人群。过去几十年的研究已将发育异常痣确定为恶性黑色素瘤的一个危险因素。此外,在罕见情况下,已证实发育异常痣会进展为黑色素瘤。在多项研究中,发育异常痣进展为恶性黑色素瘤的病例并不少见。一名35岁女性的主要症状是左脸颊出现多个瘙痒性褐色结节(2.0厘米×1.3厘米),这些结节首次出现于20年前。初诊时进行了完整切除;随后的活检证实它们是发育异常痣。它们在3年内在同一部位复发了3次,所有复发均经组织学诊断为发育异常痣。最后一次切除5年后,左脸颊出现一个褐色结节,同时左颞部、右耳后区域和左肩也出现了其他结节。这些病变经组织学诊断为恶性黑色素瘤。我们遇到了一例发育异常痣三次复发后在同一部位发生恶性黑色素瘤的病例。尽管罕见,但在涉及反复复发的发育异常痣的病例随访中,应考虑恶性黑色素瘤的可能性。