Congenital pedunculated dermal nevus and nodular malignant melanoma.

A 62-year-old woman with unremarkable past medical history was hospitalized in the Department of Internal Medicine for vomiting and abdominal pain that had appeared 3 days prior to admission. The dermatological clinical examination revealed an ulcerated brown itching 1×1 cm measuring lesion (black arrow) on the inferior right quadrant of the left breast where a pedunculated nevus (yellow arrow) had been present since birth (Fig. 1). Excision biopsy was performed which revealed a nodular malignant melanoma Breslow 5mm, Clark level IV with invasion of the dermis.

Figure 1: Congenital pedunculated dermal nevus adjacent to a nodular malignant melanoma.

Adjacent to the melanoma the histological examination showed a dermal nevus.

A metastatic workup revealed metastases to the liver spleen and bone. The patient was transferred to a specialized Oncology center for further treatment. This is a congenital dermal nevus and malignant melanoma. Although co-existence of nevus and malignant melanoma is a clinical rarity, cases have been reported in the literature [1,2].

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