Atypical Nevi
Atypical Nevus – a Melanoma Precursor? Not Exactly
HISTORY A 27-year-old woman presented with many-year history of left cheek nevus. The lesion grew in size and changed in color. Shave biopsy showed a nevus with moderate atypical melanocytic hyperplasia. Residual pigmentation of the nevus and involved histologic margins remained after the biopsy. DISCUSSION Are all atypical melanocytic lesions pre-melanomas? Should dysplastic lesions be…
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Pediatric Office Procedures with PRO-NOX™ Nitrous Oxide
HISTORY An 8-year-old girl presents with a 1 year history of dark mole of the right lower eyelid. Initially presenting as a small freckle, it grew and darkened in color. Right lower eyelid excisional biopsy was performed utilizing PRO-NOX™ nitrous oxide system. Biopsy showed intradermal nevus, combined type (primarily a common blue nevus and a…
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Mitoses in a Dysplastic Nevus
HISTORY 61-year-old man presents with 6-month history of forehead lesion. Biopsy on October 2017 showed atypical nevomelanocytic neoplasm with several mitoses (3/mm2). An excision with 5 mm margins was performed in November 2017 with negative findings. DISCUSSION This melanocytic tumor of uncertain malignant potential can also be called a MELTUMP. These lesions present a treatment…
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Left Cheek Atypical Spitzoid Nevus
HISTORY 23-year-old woman presents with lifelong history of left cheek mole changing recently. Biopsy in 8/2017 showed compound nevus with severe atypia with spitzoid features. Excision was performed on 2-9-18. The patient a history of atypical mole of the left back removed in 2017. DISCUSSION Spitz nevi are are spindle /…
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MULTIPLE ATYPICAL NEVI WITH STRONG FAMILY HISTORY OF CANCER
HISTORY 24-year-old woman presents with multiple atypical nevi. Almost all lesions had mild atypia, few had focally moderate atypia, and one on her right posterior shoulder had severe atypia and was excised with 5mm margins elsewhere. Family history is significant for melanoma in grandmother and pancreatic cancer in her father. Physical exam showed multiple 2-4…
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Atypical Nevus – Chasing Excision Margins
A 12 year old with a 10 x 7 mm pigmented nevus present since infancy undergoes excisional biopsy of the nevus for cosmetic and diagnostic purposes. Pathology evaluation finds this to be a compound nevus with moderate atypia and partial margin involvement. Pathologist recommends re-excision with 2 mm margins. Do we chase the margins as…
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