Background: Giant congenital melanocytic nevi represent a surgical challenge, particularly in cases in which the size of the nevus exceeds certain extend and malignant transformations have to be considered.
Objective: To discuss through case report considerable surgical options when extensive giant congenital melanocytic nevi with malignant transformation are encountered.
Methods: We present an unusual case of a giant congenital melanocytic nevi of the entire back of a 44-year-old patient. To achieve radical resection with direct appropriate wound closure and acceptable outcome, the integument of the entire back was excised and covered with Integra, followed by split-thickness skin grafting after stable integration of the matrix.
Results: The approach resulted in a complete excision of the tumor and acceptable cosmetic and excellent biomechanical outcome.
Conclusion: The introduced practice demonstrates a useful alternative to established methods, particularly if tumor excision in large areas and subsequent wound closure might be achieved in one procedure.