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BMJ Case Rep. 2009;2009. pii: bcr09.2008.0981. doi: 10.1136/bcr.09.2008.0981. Epub 2009 Feb 27.

Rapidly lethal metastatic melanoma arising from a large congenital melanocytic naevus.

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UCSF Medical Center, Surgery Department, S-321, 513 Parnassus Avenue, San Francisco, California, 94143-0470, USA.


A case of fatal metastatic melanoma arising from a very large congenital melanocytic naevus (VLCMN) is reported. Large congenital naevi (LCMN) are naevi >20 cm in diameter. VLCMN is used in this report to mean an extensive LCMN involving a large percentage of the body, including smaller so-called satellite naevi. A 19-year-old man with a large congenital melanocytic naevus (LCMN) presented with a new nodule on the left chest wall, which was diagnosed as a thick melanoma with synchronous axillary lymph-node metastasis. The patient developed widespread distant metastasis within weeks after surgical resection of the primary site and lymph-node basin, which was unresponsive to systemic chemotherapy and whole brain radiation therapy, and he died 7 months after diagnosis of the primary melanoma.

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