Case report of nodular melanoma within congenital melanocytic nevus- primary closure challenge

Domagoj Eljuga; Ivan Milas; Iva Kirac; Mladen Stanec; Danko Velimir Vrdoljak

doi:10.1016/j.ijscr.2016.01.022

Case report of nodular melanoma within congenital melanocytic nevus- primary closure challenge

Int J Surg Case Rep. 2016:20:84-6. doi: 10.1016/j.ijscr.2016.01.022. Epub 2016 Jan 22.

Authors

Domagoj Eljuga¹, Ivan Milas², Iva Kirac³, Mladen Stanec⁴, Danko Velimir Vrdoljak⁵

Affiliations

¹ Department for Oncoplastic and Reconstructive Surgery, University Hospital for Tumors, Ilica 197, 10 000 Zagreb, Croatia. Electronic address: domagoj@poliklinika-eljuga.hr.
² Department for Oncoplastic and Reconstructive Surgery, University Hospital for Tumors, Ilica 197, 10 000 Zagreb, Croatia. Electronic address: imilas.dr@gmail.com.
³ Department for Oncoplastic and Reconstructive Surgery, University Hospital for Tumors, Ilica 197, 10 000 Zagreb, Croatia. Electronic address: suncobran@gmail.com.
⁴ Department for Oncoplastic and Reconstructive Surgery, University Hospital for Tumors, Ilica 197, 10 000 Zagreb, Croatia. Electronic address: mstanec@net.hr.
⁵ Department for Oncoplastic and Reconstructive Surgery, University Hospital for Tumors, Ilica 197, 10 000 Zagreb, Croatia. Electronic address: danko.velimir.vrdoljak@kbcsm.hr.

Abstract

Introduction: Congenital melanocytic nevi (CMN) are present in 1-2% of newborn infants. The size of CMN defines the risk of developing melanoma which is estimated from 5-10%, especially in lesions that are located across the spine.

Presentation of case: Herein we report a case where nodular melanoma was discovered on the periphery of medium sized CMN in a high risk patient. After complete excision, the defect was reconstructed with random pattern, triple rhomboid flap.

Discussion: Melanoma that arose within medium sized CMN would leave a complex posterior lower trunk defect. We used a triple Limberg flap which was proven to be straightforward and simple method when large defects are to be covered with vital tissue. We have also showed that this type of reconstruction is suitable for high risk patients that could not withstand any complex procedures.

Conclusion: In our case, the method we choose to reconstruct the defect proved to be simple, safe and easy, especially when surgery is performed in a high risk patient.