Emily A Simons1, Jennifer T Huang2, Birgitta Schmidt3. 1. Department of Medicine, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts. Electronic address: emily_simons@hms.harvard.edu. 2. Department of Medicine, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts. 3. Department of Pathology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts. Electronic address: Birgitta.Schmidt@childrens.harvard.edu.
Abstract
BACKGROUND: Although only large congenital melanocytic nevi (CMN) are associated with a significantly high risk for malignant transformation, CMN of all sizes are prone to changes in clinical appearance in early childhood and thus are often biopsied or excised. While CMNs typically exhibit benign behavior, atypical histopathologic findings might be common and may prompt additional unnecessary procedures. OBJECTIVE: To assess the prevalence and associated clinical outcomes of atypical histopathologic features in CMN in children. METHODS: A single center retrospective study was conducted with patients 0-35 months of age with CMN diagnosed by histopathology between 1993-2013. RESULTS: One hundred seventy-nine patients with a total of 197 CMNs were identified. Cytologic atypia, architectural disorder, or pagetoid spread were present in 73% of CMN. With a mean follow up of 7.3 years, no cases of melanoma or CMN-related deaths were identified. LIMITATIONS: Our findings were based on a largely Caucasian population and might not apply to darker skin types. Our findings might not apply to older children or adults with CMN. CONCLUSION: Atypical histopathologic features of cytologic atypia, architectural disorder, and pagetoid spread are common in benign CMN of young children.
BACKGROUND: Although only large congenital melanocytic nevi (CMN) are associated with a significantly high risk for malignant transformation, CMN of all sizes are prone to changes in clinical appearance in early childhood and thus are often biopsied or excised. While CMNs typically exhibit benign behavior, atypical histopathologic findings might be common and may prompt additional unnecessary procedures. OBJECTIVE: To assess the prevalence and associated clinical outcomes of atypical histopathologic features in CMN in children. METHODS: A single center retrospective study was conducted with patients 0-35 months of age with CMN diagnosed by histopathology between 1993-2013. RESULTS: One hundred seventy-nine patients with a total of 197 CMNs were identified. Cytologic atypia, architectural disorder, or pagetoid spread were present in 73% of CMN. With a mean follow up of 7.3 years, no cases of melanoma or CMN-related deaths were identified. LIMITATIONS: Our findings were based on a largely Caucasian population and might not apply to darker skin types. Our findings might not apply to older children or adults with CMN. CONCLUSION: Atypical histopathologic features of cytologic atypia, architectural disorder, and pagetoid spread are common in benign CMN of young children.
Authors: Martino Ruggieri; Agata Polizzi; Stefano Catanzaro; Manuela Lo Bianco; Andrea D Praticò; Concezio Di Rocco Journal: Childs Nerv Syst Date: 2020-10-13 Impact factor: 1.475