Malignant melanoma arising in a pregnant African American woman with a congenital blue nevus

Abstract

Background: The incidence of cutaneous melanoma in African-Americans is relatively low. Despite the slightly greater occurrence of congenital melanocytic nevi in black persons compared with white persons, the cumulative risk of melanoma arising in these lesions is very small. In addition, the overwhelming majority of melanomas in black persons occur on nonglaborous skin where congenital melanocytic nevi are rare.

Objective: The objective was to describe and an unusual case of melanoma arising in a congenital nevus with combined features of a blue nevus on the scalp of a pregnant African-American woman.

Results: Histologic examination revealed a polypoid malignant melanoma arising in association with a congenital blue nevus in a young African-American woman. The lesion was located on the right parietal scalp and had been enlarging over the course of her pregnancy. Pathology from parotidectomy and neck dissection confirmed metastatic melanoma involving two intraparotid lymph nodes and 3 of 26 cervical lymph nodes. Despite aggressive chemotherapy, she died in 1 year after the diagnosis.

Methods: A case is reported and the literature is reviewed.

Conclusion: Clinicians must take great care in documenting and following pigmented lesions in all patients including African-American persons. Excision is indicated for lesions that undergo significant change during pregnancy.