Surgical management of giant congenital melanocytic nevus of face in the adult—outcomes and experience

Abstract

Background

Congenital melanocytic nevi (CMN), especially those of the face, cause great psychological stress to the patient. Giant-sized lesions coupled with the complex anatomy and functional demands of the region complicate treatment, more so in adults. We present our outcomes and our experience in the treatment of such lesions in the adult.

Methods

A retrospective review was carried out of all patients over the age of 14 years undergoing surgical treatment for giant CMN of the face at a tertiary care hospital. This three-year study focuses on nevi of the face; nevi elsewhere are not included. Surgical techniques employed, and complications and esthetic outcome are discussed.

Results

Seventeen patients were included in the study. Primary reconstructive procedures included tissue expansion (TE), split-thickness skin graft (STSG), full-thickness skin graft (FTSG), and free tissue transfer (FTT). Additionally, secondary procedures were required in 15 patients. Esthetic outcomes were superior with TE and FTT.

Conclusions

Size and location of the lesion, and compliance of the patient are the primary determinants of the choice of procedure. However, potential for malignant transformation and optimal esthetic results have to be also borne in mind. Treatment should be prompt, reconstruction should be individualized and follow-up should be prolonged.

Level of Evidence: Level IV, therapeutic study.