Cases reported "Nevus, Pigmented"

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1/9. Combined nevi of the conjunctiva.

    OBJECTIVE: To report the clinical and histologic features of combined nevi of the conjunctiva, a type of nevus that is not uncommon in the skin but rarely has been reported in the conjunctiva. methods: Conjunctival nevi and melanomas in the files of the University of california at san francisco eye pathology Laboratory from 1984 to 1999 were reviewed for the presence of features of both standard nevocytic nevi and blue nevi. Clinical histories and, when available, clinical photographs were obtained. RESULTS: Thirty combined nevi were discovered between 1984 and 1999. One case before 1984 had been incorrectly diagnosed as a junctional nevus. The dendritic and spindle-shaped blue nevus cells had been overlooked because they were not recognized as distinct from the standard nevocytic nevus cells. The recognition of blue as well as a brown color, a deep as well as a superficial component in the lesion, or a history of pigmentation since birth may help to establish the correct clinical diagnosis and prevent an unnecessarily deep surgical resection. Although growth of the lesion or "satellites" in some may favor a clinical diagnosis of melanoma, no lesions in this series were malignant. CONCLUSION: Despite a paucity of reports of combined nevi of the conjunctiva in the medical literature, this type of nevus, a combination of a nevocytic and a blue nevus, is common and has been overlooked in the past.
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2/9. Combined nevi of the conjunctiva.

    PURPOSE: To report the clinical and histologic features of combined nevi of the conjunctiva, a type of nevus that is not uncommon in the skin but has rarely been reported in the conjunctiva. methods: Conjunctival nevi and melanomas from the files of the University of california, san francisco, eye pathology laboratory were reviewed from 1984 to 1999 for the presence of features of both standard nevocytic nevi and blue nevi. Clinical histories and, when available, clinical photographs were obtained. RESULTS: Thirty-one combined nevi were discovered during the 15-year period between 1984 and 1999. One case before 1984 had been incorrectly diagnosed as a junctional nevus. The dendritic and spindle-shaped blue nevus cells had been overlooked because they were not recognized as distinct from the standard nevocytic nevus cells. The recognition of a blue as well as a brown color, a deep as well as a superficial component in the lesion, or a history of pigmentation since birth may help to establish the correct clinical diagnosis and prevent an unnecessarily deep surgical resection. Although growth of the lesion or "satellites" in some patients may favor a clinical diagnosis of melanoma, none of the lesions in this series were malignant. CONCLUSION: Despite a paucity of reports of combined nevi of the conjunctiva in the medical literature, this type of nevus--a combination of a nevocytic and a blue nevus--is common and has been overlooked in the past.
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3/9. Cerebral mass due to neurocutaneous melanosis: eight years later.

    Neurocutaneous melanosis (NCM) is associated most commonly with giant congenital melanocytic nevi (CMN), in particular those on the scalp or in a posterior axial location that are accompanied by satellite congenital nevi. It also can occur in patients with multiple medium-sized CMN. In general, the prognosis of those with symptomatic NCM is poor, even in the absence of malignancy, while the prognosis of those with asymptomatic NCM detected via screening varies and is more difficult to predict. Herein we report an asymptomatic patient with a giant CMN and multiple satellite nevi who had a screening magnetic resonance imaging (MRI) study at age 5 months that showed a rounded area of increased signal in the right temporal lobe on T1-weighted images, suggestive of parenchymal melanosis. This melanotic mass was resected at age 10 months, and histologic examination of the surgical specimen showed prominent perivascular collections of benign, pigment-containing melanocytes within cerebral tissue. The patient remains healthy 8 years later. His excellent long-term outcome and other reports of NCM with localized central nervous system (CNS) involvement apparent on MRI may have implications for management, including early imaging of patients with high-risk CMN and potential surgical intervention for NCM.
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4/9. Giant congenital melanocytic naevus in association with hepatic melanin deposits.

    This report describes a neonate with a giant congenital pigmented naevus over most of the trunk surface area, along with multiple satellite lesions, especially over the legs. magnetic resonance imaging of the abdomen showed large deposits of melanin in the glutei bilaterally, the rectus abdominis muscles and the liver. Treatment consisted of repeated dermabrasion of the naevus over the lower back with CO2 laser (silk touch), followed by autologous skin grafting. No evidence of malignant transformation was observed. Conclusion: Giant congenital melanocytic naevus may be associated with involvement of internal organs other than the central nervous system.
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5/9. Implantation growth of an iris melanocytic lesion simulating a ciliary body melanoma.

    A 59-year-old woman had a sectorial pigmented iris tumor in her right eye and was found to have secondary glaucoma unresponsive to medical therapy. gonioscopy revealed a satellite tumor in the inferior chamber angle, which we suspected to be a ciliary body melanoma. Subsequently, both lesions were removed completely by superior total and inferior partial iridocyclectomy. Histologic examination disclosed a spindle cell nevus with surface plaque associated with a borderline epithelioid cell nevus. This case is an example of unexpected clinical findings that may be encountered in any iris melanocytic lesion, benign or malignant, and the consequent problems of diagnosis and management.
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6/9. Severely atypical medium-sized congenital nevus with widespread satellitosis and placental deposits in a neonate: the problem of congenital melanoma and its simulants.

    We describe a neonate with a highly atypical melanocytic proliferation that arose in a medium-sized congenital nevus, in association with multiple cutaneous satellite lesions and placental deposits. The patient's pathologic findings and benign clinical course to date raise the problem of diagnosis of congenital melanoma and the importance of clinical follow-up to determine the biologic behavior of severely atypical, histologically malignant proliferations in congenital melanocytic nevi.
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7/9. Neurocutaneous melanosis associated with inferior vermian hypoplasia: MR findings.

    OBJECTIVE: We describe the MR findings of two cases of neurocutaneous melanosis (NCM) associated with inferior vermian hypoplasia (IVH). MATERIALS AND methods: Two cases of NCM associated with IVH are presented. Both patients had congenital giant hairy nevi and multiple satellite lesions. RESULTS: magnetic resonance imaging revealed IVH as well as hyperintensities in the pons and the cerebellar leptomeninges on T1-weighted images. The hyperintensities may be ascribed to the T1-shortening effect of melanin. A right parietal tumor in one patient and unilateral ventriculomegaly in another patient were also depicted. CONCLUSIONS: Magnetic resonance demonstration of the T1-shortening leptomeningeal infiltrations adds weight to the diagnosis of NCM. The implication of the concurrence of NCM and IVH is discussed.
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8/9. Congenital plantar melanocytic nevus with satellite lesions.

    We report a case of a congenital melanocytic nevus accompanied by a mucous cyst and satellite pigmented macules on the undersurface of the left great toe in a 17-year-old Japanese man. Myxoid change was confirmed by the discharge of viscous liquid when conducting biopsy of the tumor. Besides such an unusual clinical feature of the tumor, accompanying satellite lesions led us initially to consider the possibility of malignant melanoma. However, a biopsy specimen obtained from the tumor revealed the typical features of intradermal type melanocytic nevus. In a specimen obtained from the satellite pigmented lesion, there was a small mass of nevus cells underneath the basement membrane zone, suggestive of having originated from the spread of nevus cells through lymphatic vessels.
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9/9. Eruptive satellite vascular malformations after removal of a melanocytic naevus.

    The development of satellite lesions after removal of a pyogenic granuloma is well known. However, it is unusual to see this complication after the removal of a non-angiomatous lesion. We describe a patient who developed multiple small vascular lesions after excision of a dermal melanocytic naevus on her back; new lesions continued to appear over the next 20 years. Little is known about the pathogenesis of eruptive lesions developing after excision of a primary tumour. Several hypotheses, such as the influence of mechanical forces, abnormalities in the vascular system and the existence of a circulating stimulatory factor, have been suggested.
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