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Ercan A, Yalçin CE. Neonatal cutaneous melanoma with cutaneous metastasis: a case report and review of literature. Melanoma Res 2024; 34:202-205. [PMID: 38329220 DOI: 10.1097/cmr.0000000000000956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2024]
Abstract
Malignant melanoma, a rare skin cancer in children, primarily affects individuals over 10 years old. Giant congenital nevi, found in about 1% of newborns, increases the risk. However, the development of melanoma from a pre-existing giant congenital nevus diagnosed during the neonatal period is exceptionally rare. We present a case of congenital melanoma in a newborn, where nodules grew on an existing nevus on the baby's back. Literature on managing such cases was reviewed. This case highlights the importance of considering malignant transformation in congenital nevi and the challenges in their management. Due to limited reported cases over 80 years, conclusive findings on survival and treatment options are difficult to provide. Clinicians should report outcomes to develop a management algorithm for neonatal melanoma. Further studies are needed to enhance understanding of causes and treatment for patients with congenital giant hairy nevi and associated melanoma.
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Affiliation(s)
- Alp Ercan
- Department of Plastic, Reconstructive and Aesthethic Surgery, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey
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2
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Masson Regnault M, Mazereeuw-Hautier J, Fraitag S. [Early-onset melanoma (congenital, neonatal, infantile): A systematic review of literature cases]. Ann Dermatol Venereol 2020; 147:729-745. [PMID: 32563535 DOI: 10.1016/j.annder.2020.05.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2019] [Revised: 12/09/2019] [Accepted: 05/11/2020] [Indexed: 10/24/2022]
Abstract
INTRODUCTION Neonatal and infantile malignant melanoma is rare. It may be difficult to diagnose and often carries a poor prognosis. MATERIAL AND METHODS We decided to review the data on congenital, neonatal and infantile malignant melanomas in order to understand their presentation (clinical, histological, molecular), diagnosis, management and outcomes. We performed a literature search of all cases of early-onset melanoma published in PubMed from its inception to March 2019 using the following keywords: "malignant melanoma" OR "melanoma" OR "pigmented nevus" OR "malignant pigmented" AND "infantile" OR "congenital" OR "children" OR "childhood" OR "infancy" OR "neonatal". Congenital melanoma associated with maternal-foetal transmission was not included in the study. RESULTS Sixty-five articles were selected and 85 cases were included in the study. Most patients were male (sex ratio: 1.6). The average age at diagnosis was 5.5 months (minimum-maximum: 0-24 months). The main site reported for congenital melanoma was the head-and-neck area and for neonatal and infantile melanoma the trunk. Half of all patients had a metastatic disease at the time of diagnosis. In metastatic cases, the prognosis was poor with the exception of patients undergoing complete excision of the tumour and metastases. The main treatment for cutaneous melanomas and operable metastasis was surgery, and secondarily, chemotherapy/immunotherapy. CONCLUSION Neonatal and infantile malignant melanoma are rarely reported and not well-documented. It is necessary to collect additional cases to improve our knowledge of this rare disease.
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Affiliation(s)
- M Masson Regnault
- Service de dermatologie, CHU de Poitiers, université de Poitiers, hôpital Jean-Bernard, Poitiers, France; Service de dermatologie, centre de références de maladies rares de la peau et des muqueuses, CHU de Toulouse, université Paul Sabatier, hôpital Larrey, Toulouse, France.
| | - J Mazereeuw-Hautier
- Service de dermatologie, centre de références de maladies rares de la peau et des muqueuses, CHU de Toulouse, université Paul Sabatier, hôpital Larrey, Toulouse, France
| | - S Fraitag
- Groupe hospitalier Necker-Enfants malades, service d'anatomopathologie, AP-HP, Paris, France
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Baltres A, Salhi A, Houlier A, Pissaloux D, Tirode F, Haddad V, Karanian M, Ysmail‐Dahlouk S, Boukendakdji F, Dahlouk D, Allaoua F, Metref M, Djeridane A, Fraitag S, de la Fouchardière A. Malignant melanoma with areas of rhabdomyosarcomatous differentiation arising in a giant congenital nevus with RAF1 gene fusion. Pigment Cell Melanoma Res 2019; 32:708-713. [DOI: 10.1111/pcmr.12785] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2018] [Revised: 03/10/2019] [Accepted: 03/23/2019] [Indexed: 11/30/2022]
Affiliation(s)
- Aline Baltres
- Department of Biopathology Centre Léon Bérard Lyon France
| | - Aicha Salhi
- Department of Dermatology, Medical Clinic Les Orangers University of Alger Medical School Algiers Algeria
| | - Aurelie Houlier
- Department of Biopathology Centre Léon Bérard Lyon France
- CNRS 5286, INSERM U1052, Cancer Research Centre of Lyon University of Lyon, Université Claude Bernard Lyon 1 Lyon France
| | - Daniel Pissaloux
- Department of Biopathology Centre Léon Bérard Lyon France
- CNRS 5286, INSERM U1052, Cancer Research Centre of Lyon University of Lyon, Université Claude Bernard Lyon 1 Lyon France
| | - Franck Tirode
- CNRS 5286, INSERM U1052, Cancer Research Centre of Lyon University of Lyon, Université Claude Bernard Lyon 1 Lyon France
| | | | - Marie Karanian
- Department of Biopathology Centre Léon Bérard Lyon France
- CNRS 5286, INSERM U1052, Cancer Research Centre of Lyon University of Lyon, Université Claude Bernard Lyon 1 Lyon France
| | | | | | - Djazia Dahlouk
- Pediatric Department Central Hospital of Army Algiers Algeria
| | - Fateh Allaoua
- Department of Plastic Surgery Central Hospital of Army Algiers Algeria
| | - Marzak Metref
- Department of Plastic Surgery Central Hospital of Army Algiers Algeria
| | - Assya Djeridane
- Department of Dermatology Central Hospital of Army Algiers Algeria
| | - Sylvie Fraitag
- Department of Pathology, APHP Hôpital Necker‐Enfants Malades Paris France
| | - Arnaud de la Fouchardière
- Department of Biopathology Centre Léon Bérard Lyon France
- CNRS 5286, INSERM U1052, Cancer Research Centre of Lyon University of Lyon, Université Claude Bernard Lyon 1 Lyon France
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Tariq S, Shallwani H, Waqas M, Bari ME. Congenital and infantile malignant melanoma of the scalp: A systematic review. Ann Med Surg (Lond) 2017; 21:93-95. [PMID: 28794873 PMCID: PMC5540706 DOI: 10.1016/j.amsu.2017.07.042] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2017] [Revised: 07/17/2017] [Accepted: 07/17/2017] [Indexed: 12/01/2022] Open
Abstract
Congenital and infantile malignant melanomas are rare and typically carry poor prognosis. The purpose of this article was to review the data on congenital and infantile malignant melanomas of the scalp in order to understand its presentation, diagnosis, management, and outcomes of congenital melanoma of scalp. We searched PubMed, CINAHL and Cochrane databases. Ten cases of congenital and 3 cases of infantile malignant melanoma of scalp were identified. The diagnosis was confirmed by biopsy and histological analysis for confirmation. The prognosis depends on the origin of disease (congenital melanocytic nevus, transplacental metastasis, or de-novo), tumor thickness, the presence of ulceration and/or necrosis, and anatomic site (scalp lesions having poor prognosis). The most commonly used treatment of the reported cases of congenital and infantile melanoma was surgical excision of the primary lesion. Further modes of treatment may be extrapolated from the treatment of childhood and adult melanomas. Congenital and infantile malignant melanomas are rare. Surgery is the mainstay of treatment. Prognosis of the condition remains poor.
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Affiliation(s)
- Sohaib Tariq
- Section of Neurosurgery, The Aga Khan University Hospital, Karachi, Pakistan
| | - Hussain Shallwani
- Section of Neurosurgery, The Aga Khan University Hospital, Karachi, Pakistan
| | - Muhammad Waqas
- Section of Neurosurgery, The Aga Khan University Hospital, Karachi, Pakistan
| | - Muhammad Ehsan Bari
- Section of Neurosurgery, The Aga Khan University Hospital, Karachi, Pakistan
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Gharpuray-Pandit D, Coyne J, Eyden B, Banerjee SS. Rhabdomyoblastic Differentiation in Malignant Melanoma in Adults: Report of 2 Cases. Int J Surg Pathol 2016; 15:20-5. [PMID: 17172493 DOI: 10.1177/1066896906295775] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Two cases of malignant melanoma are reported in adults exhibiting rhabdomyoblastic differentiation to alert pathologists to this rare variant of malignant melanoma. One of the cases presented as a metastasis in a submandibular lymph node, and the other was a primary skin melanoma. There are only a few published reports on melanocytic tumors with rhabdomyoblastic differentiation, mainly occurring in giant congenital nevi. Both cases reported here were confirmed by immunohistochemistry. Both cases were also studied by electron microscopy, and one showed distinctive ultrastructural features of striated muscle.
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Su A, Low L, Li X, Zhou S, Mascarenhas L, Barnhill RL. De novo congenital melanoma: analysis of 2 cases with array comparative genomic hybridization. Am J Dermatopathol 2014; 36:915-9. [PMID: 25051103 DOI: 10.1097/dad.0000000000000128] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Congenital melanoma is extraordinarily rare, and 3 types have been described: transplacental metastases from the mother, de novo congenital melanoma, and melanoma occurring in association with a congenital melanocytic nevus. We describe 2 reports of array comparative genomic hybridization analysis of de novo congenital melanoma. The first patient was male, and the second was female; both had a scalp lesion present at birth, which grew quickly. The scalp mass from patient 1 showed a heterogeneous, anaplastic melanocytic neoplasm with large size and depth, high mitotic rate, ulceration, and necrosis. The scalp mass from patient 2 showed a broad melanocytic neoplasm with single cell and junctional nested proliferation at the dermal-epidermal junction and cellular, confluent aggregates of highly atypical melanocytes in the dermis with high mitotic rate. Patient 1 had lung and liver metastases detected by radiologic imaging and was treated with cisplatin, vinblastine, and dacarbazine but expired at the age of 5 months. Patient 2 developed a metastasis to the right neck with similar histologic features, and pulmonary metastases were also detected by imaging. Patient 2 is currently alive at the age of 4 years. Array comparative genomic hybridization analysis of the first case revealed loss of chromosomes 3p26.3-p21.31, 5p15.33-q23.1, 11q15.5-q13.2, 14 (complete deletion), and 15q11.1-q22.31. The second case displayed gains in chromosomes 1q21.1-q44, 2p25.3-p11.1, 2q11.1-q37.3, 6p25.3-p11.1, 7p22.3-p11.2, 7q11.1-q36.3, 8p23.3-p11.1, 8q11.1-q24.3, 9p24.3-p11.2, 9q12-q34.3, 11q13.2-q13.4, 13q11-q34, 18p11.32-p11.21, 19p13.3-p11, 19q11-q13.43, 20p13-p11.1, and 20q11.21-q13.33. In both cases, the presence of multiple chromosomal aberrations corroborated the diagnosis of melanoma.
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Affiliation(s)
- Albert Su
- *Department of Pathology and Laboratory Medicine, UCLA Medical Center, Los Angeles, CA; and Departments of †Pathology and Laboratory Medicine, and ‡Pediatrics, Division of Hematology/Oncology, Children's Hospital Los Angeles, Keck School of Medicine of University of Southern California, Los Angeles, CA
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Abstract
Although rare, congenital malignant melanoma (CMM) should be considered in the differential diagnosis of congenital skin lesions. We report a case of CMM in a 4-month-old infant presenting with an enlarging scalp mass, initially thought to be a hemangioma. Incisional biopsy of the lesion showed a compound congenital nevus with atypical cells suggestive of a proliferative nodule versus malignancy on histopathology. Subsequent excisional biopsy revealed malignant melanoma, and further workup confirmed extensive disease with distant metastases. Cytogenetic analysis of both the tumor sites showed highly abnormal karyotypes including pseudotetraploidy, telomere associations, and evidence of gene amplification, all consistent with malignancy. Fluorescence in situ hybridization demonstrated amplification of the MYC gene, with no copy number changes in CDKN2A (INK4/ARF), PTEN, or Cyclin D1. Our report details the cytogenetic and molecular studies of CMM, which provide insight into the biologic behavior of the lesions and may confirm diagnosis when histopathology is not determinant.
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Giant congenital melanocytic naevus with proliferative nodules mimicking congenital malignant melanoma: a case report and review of the literature of congenital melanoma. Case Rep Dermatol Med 2013; 2013:473635. [PMID: 23401804 PMCID: PMC3562615 DOI: 10.1155/2013/473635] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2012] [Accepted: 12/24/2012] [Indexed: 11/18/2022] Open
Abstract
Congenital malignant melanoma (CMM) is a rare condition that is defined as malignant melanoma recognized at birth. CMM may develop in utero in one of three ways: (1) transmission by metastasis through the placenta from a mother with melanoma; (2) primary melanoma arising within a giant congenital melanocytic naevus (GCMN); (3) primary de novo cutaneous CMM arising in utero. CMM can be confused clinically and histologically with benign proliferative melanocytic lesions such as giant congenital nevi. We describe the case of a patient presenting a GCMN with proliferative nodules, clinically and dermoscopically resembling a CMM, demonstrating the importance of caution in making a diagnosis of MM and highlighting the possibility that benign lesions as GCMN can mimic a malignant melanoma in this age group.
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Mitotically Active Proliferative Nodule Arising in a Giant Congenital Melanocytic Nevus. Am J Dermatopathol 2013; 35:e16-21. [DOI: 10.1097/dad.0b013e318265fe12] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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10
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Abstract
The aim of this review was to document and discuss diagnostic problems associated with divergent differentiation ('metaplastic change') in malignant melanomas, defined as the development in these tumours of morphologically, immunohistochemically and/or ultrastructurally recognizable non-melanocytic cell or tissue components. Types of divergent differentiation reported in malignant melanoma include: fibroblastic/myofibroblastic, Schwannian and perineurial, smooth muscle, rhabdomyosarcomatous, osteocartilaginous, ganglionic and ganglioneuroblastic, neuroendocrine and probable epithelial. Divergent differentiation is certainly a rare phenomenon and, when it occurs, can be missed by unwary pathologists and lead to diagnostic uncertainty. A carefully chosen immunohistochemical panel and the input of electron microscopy can help to clarify the nature of the cellular differentiation of these tumours and lead to a correct final diagnosis. The clinical significance of such aberrations is uncertain, nor are the underlying mechanisms as yet well defined.
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Affiliation(s)
- S S Banerjee
- Christie Hospital NHS Foundation Trust, Manchester, UK
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11
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Verschuur ECA, van der Biezen JJ, van Wingerden JJ. The Trojan congenital melanocytic naevus: harbinger of childhood melanoma: case report and review of the literature. EUROPEAN JOURNAL OF PLASTIC SURGERY 2006. [DOI: 10.1007/s00238-006-0054-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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12
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Chan YC, Giam YC. A retrospective cohort study of Southeast Asian patients with large congenital melanocytic nevi and the risk of melanoma development. J Am Acad Dermatol 2006; 54:778-82. [PMID: 16635657 DOI: 10.1016/j.jaad.2006.02.063] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2005] [Revised: 02/21/2006] [Accepted: 02/26/2006] [Indexed: 11/18/2022]
Abstract
BACKGROUND The lifetime risk of developing melanoma in Caucasian patients with large congenital melanocytic nevi (LCMN) is estimated to be between 4.5% and 10%. Cohort studies of LCMN and the risk of melanoma development in an Asian population are not available. OBJECTIVE We sought to determine the risk of melanoma development in a retrospective cohort of patients presenting with LCMN to a dermatology tertiary referral center in Singapore from January 1989 to December 2004. METHODS Patients with congenital melanocytic nevi (CMN) that covered at least 5% of the body surface area were included in the study. Data were obtained from electronic records and photographic documentation. A search for malignancy was done using the National Cancer Registry database. RESULTS In all, 39 patients (23 male and 16 female) met the study criteria of LCMN; 15 of 39 patients also met the criteria of having a giant CMN (ie, a CMN that is predicted to be at least 20-cm diameter in adulthood). There were 29 Chinese, 6 Malay, 1 Indian, and 3 Caucasian patients. Their ages ranged from 23 months to 60 years (mean 18.8 years). They presented at a mean age of 26 months and were followed up for an average of 16.9 years. The size of the LCMN ranged from 5% to 40% of body surface area, with a mean of 12.2%. The most common sites were the back (54%), lower limb (28%), and abdomen (26%). Satellite lesions were present in 22 patients. Magnetic resonance imaging of the head or thoracolumbar spine was performed in 7 patients with LCMN on the scalp/face or back, respectively; all produced normal findings. Only one patient was treated: he had carbon-dioxide laser ablation and Q-switched neodymium:yttrium-aluminum-garnet laser treatment of a small part of his LCMN. Skin biopsies were done in 5 patients who had developed nodules; histology showed no evidence of malignancy. No patients had developed any form of malignancy. LIMITATIONS The addition of 3 adult patients born before the start of the cancer registry may have led to survivor bias. The small sample size did not allow a precise estimate of the risk of melanoma development in our study population. CONCLUSION The risk of melanoma development in LCMN within a predominantly Southeast Asian cohort appears to be very low. Prophylactic complete excision of LCMN is ideal, but seldom achievable. Hence, patient education, regular melanoma surveillance, and biopsy of suspicious lesions are very important.
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Abstract
Congenital malignant melanoma (MM) is an uncommon condition that is defined as MM recognized at birth. Its incidence is difficult to determine because of the small number of reported cases and because of problems associated with diagnosis. Generally, Spitz naevus and melanoma have many clinical and histopathological similarities, so it is difficult to differentiate between the two. We describe a rare case of congenital MM in which differential diagnosis from Spitz naevus was problematic. In addition, we review the literature and comment on the prognostic differences among the three types of congenital and infantile MM.
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Affiliation(s)
- J Asai
- Department of Dermatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi, Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan
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Richardson SK, Tannous ZS, Mihm MC. Congenital and infantile melanoma: review of the literature and report of an uncommon variant, pigment-synthesizing melanoma. J Am Acad Dermatol 2002; 47:77-90. [PMID: 12077586 DOI: 10.1067/mjd.2002.120602] [Citation(s) in RCA: 100] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Congenital and infantile types of melanoma are uncommon conditions for which there are limited epidemiologic data. The number of reported cases is small with several ascribed etiologies. We review the literature and report the first documented case, to our knowledge, of pigment-synthesizing melanoma in an infant. Reported cases of congenital and infantile melanoma were identified and categorized on the basis of disease origin. Dermatopathologic specimens from an infant given a diagnosis of pigment-synthesizing melanoma are described. Disease arising from medium and large/giant congenital nevi was most common, whereas reports of de novo and transplacental disease were infrequent. Death of approximately 40% of patients was noted within 18 months of diagnosis. Male infants accounted for approximately 74% of cases. The most commonly affected anatomic sites were the head and neck. The prognosis for congenital and infantile melanoma is poor. The high incidence of head-and-neck involvement and male predominance for disease suggest dispositions for both anatomic disease localization and sex.
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Affiliation(s)
- Stephen K Richardson
- Dermatopathology Unit, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, Boston, MA 02114-2696, USA
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Affiliation(s)
- A Spatz
- Department of Pathology, Institut Gustave-Roussy, 94805 Villejuif Cedex, France
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