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Journal of the American Academy of Dermatology
Volume 74, n° 6
pages 1128-1134 (juin 2016)
Doi : 10.1016/j.jaad.2016.01.024
accepted : 18 January 2016
Original Articles

Characteristics, treatment, and survival of invasive malignant melanoma (MM) in giant pigmented nevi (GPN) in adults: 976 cases from the National Cancer Data Base (NCDB)
 

Ashley E. Turkeltaub, BS b, Todd A. Pezzi, BS b, Christopher M. Pezzi, MD c, Harry Dao, MD a, b,
a Department of Dermatology, Houston, Texas 
b Baylor College of Medicine, Houston, Texas 
c Department of Surgery, Abington Hospital-Jefferson Health, Abington, Pennsylvania 

Reprint requests: Harry Dao, Jr, MD, Department of Dermatology, Baylor College of Medicine, Jamail Specialty Care Center, 1977 Butler St, Suite E6.200, Houston, TX 77030.Department of DermatologyBaylor College of MedicineJamail Specialty Care Center1977 Butler StSuite E6.200HoustonTX77030
Abstract
Background

Malignant melanoma (MM) arising in a giant pigmented nevus (GPN) is a rare disease in adults with no large series published to our knowledge.

Objective

We sought to describe the characteristics, treatment, and survival of MM in GPN for adults.

Methods

Adults with invasive MM in GPN (n = 976) reported to the National Cancer Data Base from 1998 to 2012 were evaluated for patient and tumor characteristics, treatment, and survival. For comparison, data from adults with invasive superficial spreading melanoma (SSM) (n = 111,870) and nodular melanoma (n = 35,962) were used.

Results

Compared with patients with SSM, patients with MM in GPN had a thicker Breslow depth, more positive lymph nodes, and distant metastasis more frequently. Multivariate analysis identified age older than 65 years, Breslow thickness greater than 2 mm, presence of ulceration, presence of distant metastasis, and positive margins as independent predictors of survival in patients with MM in GPN. At all stages, having MM in GPN has similar overall survival compared with SSM.

Limitations

The study is retrospective and registry-based.

Conclusions

Invasive MM in GPN occurs in adults, with overall survival similar to SSM. Clinicians should be aware of the continued risk of MM in adults with GPN with low threshold for biopsy.

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Key words : giant congenital nevi, giant pigmented nevi, malignant melanoma, National Cancer Data Base, nodular melanoma, superficial spreading melanoma

Abbreviations used : AJCC, CI, GPN, HR, MM, NCDB, NM, SSM



 Funding sources: None.
 Conflicts of interest: None declared.
 The views expressed in this article are the authors' own and not an official position of any institution.



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