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Bompy L, Levasseur J, Hallier A, Fraitag S, Aubriot-Lorton MH, Bonniaud B, Zwetyenga N. [Recurrent nevus: Case-report about a pagetoid form occurring from a congenital nevus in infancy]. ANN CHIR PLAST ESTH 2018; 63:349-352. [PMID: 29625761 DOI: 10.1016/j.anplas.2018.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Accepted: 03/05/2018] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Recurrent nevus (RN) is a cutaneous benign tumour with similarities with malignant lesions. Typically, it occurs after a partial resection of commun-acquired nevus. Its incidence varies from 0.3 to 27% according to the studies. We present here a pediatric case of a pagetoid form of a recurrent nevus occurring from a congenital nevus. CASE REPORT A congenital nevus was removed from a 9-month-old girl. Pathologists concluded to a commun-acquired nevus of complete exeresis. Two other cutaneous lesions appeared and we decided to realise a total removal. Analysis showed a recurrent nevus with some atypical histological features. No recurrence has occurred during the three post-operative of follow-up. DISCUSSION It is an interesting case because of the occurrence of a RN after the removal of a congenital nevus in a child. Furthermore, it displayed some atypical histological features. Practicians, such as surgeons, dermatologists or pathologists, have to be aware of the risk of misdiagnosis with this lesion, which presents some similarities with SSM melanoma. It would be interesting to determinate some markers to statuate about its benign feature. There is no management recommendation about this lesion but it seems to be necessary to remove it to eliminate a malignant tumour.
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Affiliation(s)
- L Bompy
- Service de chirurgie orale, chirurgie maxillo-faciale, chirurgies plastique, esthétique et reconstructive et de la main, boulevard de Lattre-de-Tassigny, CHU de Dijon, 21079 Dijon, France.
| | - J Levasseur
- Service de chirurgie orale, chirurgie maxillo-faciale, chirurgies plastique, esthétique et reconstructive et de la main, boulevard de Lattre-de-Tassigny, CHU de Dijon, 21079 Dijon, France.
| | - A Hallier
- Service de chirurgie orale, chirurgie maxillo-faciale, chirurgies plastique, esthétique et reconstructive et de la main, boulevard de Lattre-de-Tassigny, CHU de Dijon, 21079 Dijon, France.
| | - S Fraitag
- Service d'anatomopathologie, hôpital Necker-Enfants-malades, AP-HP, 149, rue de Sèvres, 75743 Paris, France; Université Paris Descartes-Sorbonne Paris Cité et institut IMAGINE, Paris, France.
| | - M-H Aubriot-Lorton
- Service d'anatomopathologie, boulevard de Lattre-de-Tassigny, CHU de Dijon, 21079 Dijon, France.
| | - B Bonniaud
- Service de dermatologie, boulevard de Lattre-de-Tassigny, CHU de Dijon, 21079 Dijon, France.
| | - N Zwetyenga
- Service de chirurgie orale, chirurgie maxillo-faciale, chirurgies plastique, esthétique et reconstructive et de la main, boulevard de Lattre-de-Tassigny, CHU de Dijon, 21079 Dijon, France; Université de Bourgogne-Franche-Comté, Inserm 1231, Lipids Nutrition Cancer Team Nutox, boulevard Jeanne-d'Arc, 21000 Dijon, France.
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Réguerre Y, Vittaz M, Orbach D, Robert C, Bodemer C, Mateus C, Plantaz D, Plouvier E, Lutz P, Rakotonjanahary J, Fraitag S, Martin L. Cutaneous malignant melanoma in children and adolescents treated in pediatric oncology units. Pediatr Blood Cancer 2016; 63:1922-7. [PMID: 27348579 DOI: 10.1002/pbc.26113] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2016] [Revised: 06/01/2016] [Accepted: 06/02/2016] [Indexed: 11/10/2022]
Abstract
OBJECTIVES Recent progress in the understanding of tumor biology and new targeted therapies has led to improved survival in adults with malignant melanoma (MM). MM is rare in children, especially before puberty. We report here our experience with pediatric patients with MM, describe the clinical presentation, treatment and evolution, and compare prepubescent and postpubescent disease. METHODS A retrospective, descriptive, national multicenter study was undertaken of 52 cases of MM in children and adolescents. Demographic, histopathology, treatment evolution data, and survival distributions are described. RESULTS Median age was 15 years (5-18). The tumors were often amelanotic (45%) and raised (83%), and Breslow thickness was greater than 4 mm in 35% of cases. Histological examination showed superficial spreading (n = 16) or spitzoid (n = 16) or nodular (n = 9) pattern. Twelve children (23%) were less than 10 years of age. The spitzoid histotype was more frequent in prepubescent children (seven of 12). Seventeen patients relapsed, of whom four had skin lesions initially diagnosed as benign. Ten patients died after relapse. Five-year event-free survival and overall survival were 62.7% (95% confidence interval [CI]: 45.3-76) and 75.5% (95% CI: 56.8-87.1), respectively. CONCLUSIONS MM appears to be different in prepubescent children, of whom most had a spitzoid histotype. Diagnosis can be difficult, leading to delay in treatment. New biological tools to identify targets for treatment in MM and to differentiate spitzoid melanomas from Spitz nevi now exist. As effective targeted therapies are now available, we recommend requesting biological examination of all melanocyte-derived skin lesions in children that could be malignant.
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Affiliation(s)
- Yves Réguerre
- Oncology and Hematology Unit, CHU de Saint Denis de La Réunion, Saint Denis, France. French Pediatric Rare Tumor Group (groupe Fracture).
| | - Marie Vittaz
- Pediatric Departement, CH Le Mans, Le Mans, France
| | - Daniel Orbach
- Department of Pediatrics, Adolescent, Young Adult Oncology, Institut Curie, Paris, France. French Pediatric Rare Tumor group (groupe Fracture)
| | - Caroline Robert
- Dermatology Department, Gustave Roussy Cancer Campus, Villejuif, France
| | - Christine Bodemer
- Dermatology Department, Necker-Enfants Malades Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Christina Mateus
- Dermatology Department, Gustave Roussy Cancer Campus, Villejuif, France
| | - Dominique Plantaz
- Oncology and Hematology Unit, Grenoble University Hospital, Grenoble, France
| | - Emmanuel Plouvier
- Oncology and Hematology Unit, Besançon University Hospital, Besançon, France
| | - Patrick Lutz
- Oncology and Hematology Unit, Strasbourg University Hospital, Strasbourg, France
| | | | - Sylvie Fraitag
- Pathology Department, Necker-Enfants Malades Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Ludovic Martin
- Dermatology Department, Angers University Hospital, Angers, France
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Adjadj L, Debelmas A, Franois-Fiquet C, Diner PA, Buis J, Franchi G, Chrétien-Marquet B, Vazquez MP, Picard A, Kadlub N. [Orbital congenital nevi: Principles of treatment about 51 cases]. ANN CHIR PLAST ESTH 2014; 61:29-38. [PMID: 25524448 DOI: 10.1016/j.anplas.2014.11.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2014] [Accepted: 11/08/2014] [Indexed: 11/16/2022]
Abstract
INTRODUCTION The incidence of congenital nevi is one over 20,000 newborns per year, 14 % of them are located in the head and neck area. Nevi of the orbital region are particularly difficult to handle on the aesthetic and functional side. The objectives of this study were to conduct an analysis of different clinical presentations of congenital nevi of the eyelid orbital region in children to establish a treatment algorithm. MATERIEL AND METHODS We realised a bi-centric retrospective study including 51 children with orbito-palpebral congenital nevi. We analysed the different clinical presentations, their treatments and their results. RESULTS Nineteen underwent direct suture excision; three a total skin graft; 15 a combination of treatments, among them four underwent tissular expansion and 14 patients were not operated and clinically followed-up. The average follow-up time was 6.6 years. In 33 cases residual nevic area was still present. The postoperative sequelae were: dyschromia (n=17), anatomical deformation of the eye (n=10), nevi outbreaks (n=8), internal canthus deformation (n=5) and ectropion (n=1). CONCLUSION The results of our study show that therapeutic abstention is preferred when the aesthetic wrong is accepted by the patient and when there is not a higher risk of malignant degeneration. In order to minimise the risk of postoperative sequelae, we propose a therapeutic algorithm for the management of congenital orbital nevi.
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Affiliation(s)
- L Adjadj
- Service de chirurgie maxillo-faciale et plastique, hôpital Necker-Enfants-Malades, AP-HP, 149, rue de Sèvres, 75015 Paris, France
| | - A Debelmas
- Service de chirurgie maxillo-faciale et plastique, hôpital Necker-Enfants-Malades, AP-HP, 149, rue de Sèvres, 75015 Paris, France
| | - C Franois-Fiquet
- Service de chirurgie plastique, CHU de Reims, 51000 Reims, France; UFR de médecine, université de Reims-Champagne-Ardennes, 51000 Reims, France
| | - P-A Diner
- Service de chirurgie maxillo-faciale et plastique, hôpital Necker-Enfants-Malades, AP-HP, 149, rue de Sèvres, 75015 Paris, France; Centre de référence des malformations faciales et de la cavité buccale, MAFACE, AP-HP, 75015 Paris, France
| | - J Buis
- Service de chirurgie maxillo-faciale et plastique, hôpital Necker-Enfants-Malades, AP-HP, 149, rue de Sèvres, 75015 Paris, France; Centre de référence des malformations faciales et de la cavité buccale, MAFACE, AP-HP, 75015 Paris, France
| | - G Franchi
- Service de chirurgie maxillo-faciale et plastique, hôpital Necker-Enfants-Malades, AP-HP, 149, rue de Sèvres, 75015 Paris, France; Centre de référence des malformations faciales et de la cavité buccale, MAFACE, AP-HP, 75015 Paris, France
| | - B Chrétien-Marquet
- Service de chirurgie maxillo-faciale et plastique, hôpital Necker-Enfants-Malades, AP-HP, 149, rue de Sèvres, 75015 Paris, France
| | - M-P Vazquez
- Service de chirurgie maxillo-faciale et plastique, hôpital Necker-Enfants-Malades, AP-HP, 149, rue de Sèvres, 75015 Paris, France; Centre de référence des malformations faciales et de la cavité buccale, MAFACE, AP-HP, 75015 Paris, France; Université Paris Descartes, 75005 Paris, France; UMRS 972, équipe 5, Inserm, centre de recherche des Cordeliers, 75006 Paris, France
| | - A Picard
- Service de chirurgie maxillo-faciale et plastique, hôpital Necker-Enfants-Malades, AP-HP, 149, rue de Sèvres, 75015 Paris, France; Centre de référence des malformations faciales et de la cavité buccale, MAFACE, AP-HP, 75015 Paris, France; Université Paris Descartes, 75005 Paris, France; UMRS 972, équipe 5, Inserm, centre de recherche des Cordeliers, 75006 Paris, France
| | - N Kadlub
- Service de chirurgie maxillo-faciale et plastique, hôpital Necker-Enfants-Malades, AP-HP, 149, rue de Sèvres, 75015 Paris, France; Centre de référence des malformations faciales et de la cavité buccale, MAFACE, AP-HP, 75015 Paris, France; Université Paris Descartes, 75005 Paris, France; UMRS 972, équipe 5, Inserm, centre de recherche des Cordeliers, 75006 Paris, France.
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