Pigmented Lesion - congenital nevus

Diagnosis: Pigmented Lesion - congenital nevus

This is a 19 year old female patient with a benign pigmented lesion that shows congenital nevus on abdomen

Clinical Presentation

This is a 19 year old female patient with a benign pigmented lesion that shows congenital nevus on abdomen

Clinical History

Submitted by Ellie Goulding MD. Originally posted November 30, 2016.

Treatment

See case discussion.

Differential Diagnosis

• Congenital melanocytic nevus (small/medium) • Melanoma • Café au lait macule (large) • Plexiform neurofibroma • Becker nevus

Key Learnings

• Congenital melanocytic nevus ≥20cm (projected adult size) — "bathing trunk nevus" when on trunk • ~5-10% lifetime risk of melanoma — higher than small CMN • Neurocutaneous melanosis: leptomeningeal melanocytosis in patients with large CMN — seizures, hydrocephalus • Satellite nevi (smaller CMN elsewhere) common and correlate with NCM risk • Prophylactic excision: controversial — does not eliminate melanoma risk (can arise in deeper tissues/CNS) • MRI brain/spine recommended for large axial CMN or multiple satellites

Tags: pigmented, lesion, congenital, nevus, ellie goulding md