Mateuszczyk Mateusz K, Świerczyńska-Mróz Karolina, Chlebicka Iwona, Szepietowski Jacek C
Department of Dermatology, Venereology, and Allergology, Wroclaw Medical University, Wroclaw, Poland.
Postepy Dermatol Alergol. 2023 Aug;40(4):561-566. doi: 10.5114/ada.2023.128718. Epub 2023 Jun 18.
Congenital melanocytic nevi (CMN) are benign lesions composed of clonal proliferations of melanocytes. Although medium-sized CMN are common and generally remain benign throughout a person's lifetime, they may be precursors of melanoma. There is a limited number of studies focused on the risk of melanoma in solitary, medium-sized, congenital melanocytic nevus; therefore, the incidence of malignant transformation and guidelines for treatment are not well established.
Prompted by the limited data, we conducted this study to gather more information about medium-sized CMN, to optimize clinical care. We share our analysis of surgically removed medium-sized CMN.
A total of 10 patients with non-multiple, medium-sized, congenital melanocytic nevus were included in this study. Lesions were removed using surgical procedures.
In most of the cases the reason for excision of the medium-sized CMN was evolution of the lesion or aesthetic considerations reported by the patients. In 2 cases, due to the large size of the lesions, serial excisions were performed, while other CMN were removed surgically using simple excision technique. Eight of 10 medium-sized CMN were histologically described as benign, and 2 cases of malignant transformations were reported.
According to our clinical experience and knowledge, we recommend managing patients on an individual basis, taking into consideration multiple clinical attributes. In our opinion, long-lasting observation is the management of choice, and if there is need of surgery, we recommend total simple or staged excision depending on nevus size.
先天性黑素细胞痣（CMN）是由黑素细胞克隆性增殖形成的良性病变。尽管中等大小的CMN很常见，并且在人的一生中通常保持良性，但它们可能是黑色素瘤的前驱病变。针对孤立性中等大小先天性黑素细胞痣发生黑色素瘤风险的研究数量有限；因此，恶性转化的发生率和治疗指南尚未明确。
鉴于数据有限，我们开展本研究以收集更多关于中等大小CMN的信息，优化临床护理。我们分享对手术切除的中等大小CMN的分析。
本研究共纳入10例非多发性中等大小先天性黑素细胞痣患者。采用手术方法切除病变。
在大多数病例中，切除中等大小CMN的原因是病变进展或患者报告的美学考虑因素。2例因病变较大进行了分期切除，其他CMN采用简单切除技术手术切除。10例中等大小CMN中有8例组织学表现为良性，报告了2例恶性转化病例。
根据我们的临床经验和知识，我们建议根据个体情况管理患者，考虑多种临床特征。我们认为，长期观察是首选的管理方式，如果需要手术，我们建议根据痣的大小进行完全简单切除或分期切除。
