Indication for early excision of the giant congenital nevus
López Gutiérrez, J.C.; García Palacios, M.; Díaz, M.; Soto, C.; Ros, Z.
Cirugia Pediatrica Organo Oficial de la Sociedad Espanola de Cirugia Pediatrica 23(3): 165-169
2010
ISSN/ISBN: 0214-1221 PMID: 23155663 Document Number: 640482
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.