Malignant Melanoma Arising From a Giant Congenital Melanocytic Nevus in a 3-Year Old: Review of Diagnosis and Management

Abstract

The course of patient described in this case report is typically: patient reports an intermittent remission of the symptoms, intraoral examination may reveal dental restorations and periodontal diseases, but the clinician should keep in mind that even the tooth involved can appear healthy. Some authors claim that extra-oral fistulas are more common in the children and adolescents because the teeth are not yet fully erupted and the alveolar processes is not fully developed and so roots are more deeply seated. 6-10 However, most case reports available in the literature are predominantly of adults and thus do not support this theory.Odontogenic cutaneous fistula typically arises from periapical infections around the root apices as a result of pulpal necrosis due to penetrant caries or traumatic injury. Routine tests used to locate the involved teeth include pulp sensitivity tests and radiographic analysis. In the clinical case described here, the radiographies clearly revealed pericoronaritis and boneless which the cause of suppuration and fistula. [11][12][13] As far as definitive treatment is concerned, root canal or surgical extraction is the treatment of choice. After surgical treatment of the pathogenic tooth the fistula often heals without furthers intervention by 14 days. Healing occurs by secondary intention and occasionally a residual scar may be persist after a few months. In these cases, surgery may be indicated to improve aesthetics. In this case report we have preferred to have surgical excision in order to speed up the healing process.In conclusion, a dental etiology must always be considered for any cutaneous fistula in the head or in the neck region. 2,3,13 -16 Elimination of the dental source of infection results in resolution of the fistula and the healing of the fistula is expected within 5 to 14 days. In case with of restorable teeth, even just the elimination of the infection through endodontic treatment leads to resolution of the fistula. 2,8,17 The case here described is particular because the fistula was caused by a pericoronaritis and not by a dental necrosis. The pericoronaritis started from the third molar, whose existence was ignored, in an old edentulous woman. This case teaches that clinicians should always look for odontogenic causes of cutaneous fistula, even though they seem unlikely.

Giant congenital melanocytic nevus in an Afghan child

“…Giant congenital melanocytic nevus is a large hyperpigmented lesions commonly present since birth, these patches are trend to malignant transformation in the first 3–5 years of patients' life. 7 , 8 The GCMN is occurred 1 in 20,000 to 1 in 50,000 births. 2 Due to its tendency to the malignant transformation, increased risk of neurological abnormalities, and cosmetic reasons the timely treatment is essential.…”

Giant Congenital Melanocytic Nevus in an Afghan Child

“…GCMN is a large hyperpigmented lesions commonly present since birth, these patches are trend to malignant transformation in the first 3 to 5 years of patients' life 5,6 . The GCMN is occurred 1 in 20000 to 1 in 50000 births 2 .…”

Association of novel MUC16, MAP3K15 and ABCA1 mutation with giant congenital melanocytic nevus

“…GCMN usually presents as well-defined brown lesions with a flat or papillary surface and hirsutism. It is now well accepted that GCMN is closely associated with malignant melanoma [ 3 ], but the precise extent of the risk remains unknown. The lifetime risk of melanoma in patients with GCMN has been reported to be between 10 and 15% [ 4 , 5 ].…”