Intradermal penile melanocytic tumor with complete resection in an adolescent: Clinical case

Main Article Content

Juan Carlos García-Lino https://orcid.org/0009-0000-7313-565X
Alma Patricia González https://orcid.org/0000-0002-3401-7519
Luis Fernando González-Cortés https://orcid.org/0000-0003-0064-6306
Ma. Teresa Cano-Rodríguez https://orcid.org/0000-0002-1948-459X
Jilian Vanessa Corona-Jiménez https://orcid.org/0009-0003-3291-5774
Carlos Paque-Bautista https://orcid.org/0000-0002-2658-0491
Gloria Patricia Sosa-Bustamante https://orcid.org/0000-0002-8460-4965
Daniel Pascual-Jiménez https://orcid.org/0000-0002-4470-3408
Claudia Mariana Hernández-Robles https://orcid.org/0009-0007-4084-9315
Helena Vidaurri-de la Cruz https://orcid.org/0000-0002-7617-1610
Mario Murguía-Pérez https://orcid.org/0000-0003-4260-389X

Keywords

Nevus, Pigmented, Adolescent, Penis, Skin Neoplasms

Abstract

Abstract  


Background: Pigmented dermatoses are a frequent reason for pediatric dermatologic care, especially melanocytic nevi. Although they have a low risk of progression to melanoma, they may require excision if they affect the patient's quality of life due to their location in visible sites or specific areas such as the genitals. We present the unusual case of an adolescent with a melanocytic nevus located on the genitals, who underwent surgical management.


Clinical case: 11-year-old male patient who presented with a melanocytic nevus affecting the penis and with no additional abnormalities on the remainder of the physical examination. Due to the impact on quality of life, the entire pigmented plaque was excised with a 5-mm margin of healthy skin, and reconstruction of the cutaneous defect and the foreskin was performed. The histopathological study reported a completely excised intradermal melanocytic neurotized nevus, with no malignant criteria.


Conclusions: Congenital melanocytic nevi can be treated with complete excision when they affect patients' quality of life due to their location in sensitive sites, such as the genitals. Adequate reconstruction improves the patient's prognosis, as these types of lesions often cause anxiety and depression, especially in adolescents.

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References

1. Rodríguez G, Laya C, Sosa G, et al. Nevus recurrente melanocítico intradérmico lipomizado de labio. Reporte de caso. ODOUS Científica. 2022:23(2):135-43. doi: 10.54139/odousuc.v23i2.534

2. Liu J, Mei L, Yu J, et al. Epidemiological characteristics and hospitalization burden analysis of pediatric inpatients with melanocytic nevi in China from 2016 to 2021: A nationwide retrospective study of 13,396 cases. J Plast Reconstr Aesthet Surg. 2024;95:62-72. doi: 10.1016/j.bjps.2024.04.003

3. Nevos melanocíticos. En: Guzmán R, ed. Dermatología. Atlas, Diagnóstico y Tratamiento. Octava edición. McGraw-Hill Education; 2024.

4. Fernandez-Flores A. Conceptos modernos en tumores melanocíticos. Actas Dermo-Sifiliográficas. 2023;114(5):402-12. doi: 10.1016/j.ad.2023.01.001

5. Maniaci JL, Raghavan SS. PRAME Expression in Melanocytic Proliferations in Special Sites. Cutis. 2024;113(1):43-7. doi: 10.12788/cutis.092

6. Calim-Gurbuz B, Pehlivanoglu B, Soylemez-Akkurt T, et al. Skin Lesions in Children: Evaluation of Clinicopathological Findings. Turk Patoloji Derg. 2023;39(3):192-8. doi: 10.5146/tjpath.2023.01599

7. Fuentes-Suárez A, Domínguez-Soto L. El menosprecio de la Dermatología basado en la ignorancia y su repercusión en la salud del paciente. Rev Med Inst Mex Seguro Soc 2015;53(2):250-3. Disponible en: https://www.redalyc.org/pdf/4577/457744936021.pdf

8. Yeh I. Melanocytic naevi, melanocytomas and emerging concepts. Pathology. 2023;55(2):178-86. doi: 10.1016/j.pathol.2022.12.341

9. Tempark T, Whaidee K, Bongsebandhu-Phubhakdi C, et al. Prevalence of skin diseases in school-age children. Fam Pract. 2022;39(3):340-5. doi: 10.1093/fampra/cmab164

10. Anderson-Vildósola J, Hernández-Martín Á. Addressing Frequently Asked Questions and Dispelling Myths About Melanocytic Nevi in Children. Dermatol Clin. 2022;40(1):51-9. doi: 10.1016/j.det.2021.09.005

11. De la Fouchardiere A, Blokx W, van Kempen LC, et al. Dermatopathology Working Group; EORTC Melanoma Group; EURACAN. ESP, EORTC, and EURACAN Expert Opinion: practical recommendations for the pathological diagnosis and clinical management of intermediate melanocytic tumors and rare related melanoma variants. Virchows Arch. 2021;479(1):3-11. doi: 10.1007/s00428-020-03005-1

12. Jurado-Santa Cruz, F, Medina-Bojórquez, A, Gutiérrez-Vidrio, et al Prevalencia del cáncer de piel en tres ciudades de México. Rev Med Inst Mex Seguro Soc. 2011;49(3):253-8. Disponible en: https://www.redalyc.org/articulo.oa?id=457745502006

13. Elder DE, Bastian BC, Cree IA, et al. The 2018 World Health Organization classification of cutaneous, mucosal, and uveal melanoma: Detailed analysis of 9 distinct subtypes defined by their evolutionary pathway. Arch Pathol Lab Med. 2020;144(4):500-22. doi: 10.5858/arpa.2019-0561-ra

14. Dessinioti C, Geller AC, Stratigos AJ. A review of nevus-associated melanoma: What is the evidence? J Eur Acad Dermatol Venereol. 2022;36(11):1927-36. doi: 10.1111/jdv.18453

15. Lee KJ, Janda M, Stark MS, et al. On naevi and melanomas: two sides of the same coin? Front Med (Lausanne). 2021;8:635316. doi: 10.3389/fmed.2021.635316

16. Huibers A, Leong SP, Kashani-Sabet M, et al. Prognostic Value of Nevus-Associated Melanoma in Patients with Melanoma. Ann Surg Oncol. 2025;32(5):3189-97. doi: 10.1245/s10434-025-16945-2

17. McMullan P, Grant-Kels JM. Childhood and adolescent melanoma: An update. Clin Dermatol. 2025;43(1):16-23. doi: 10.1016/j.clindermatol.2025.01.010

18. Carlos-Ortega B, Montes de Oca-Monroy F, Isyta-Morales A. Dermatoscopia de las metástasis de melanoma maligno cutáneo. Informe de caso. Rev Med Inst Mex Seguro Soc. 2009;47(1):73-6. Disponible en: https://www.redalyc.org/articulo.oa?id=457745512017

19. Cohen PR, Zito PM. Cutaneous Melanoacanthoma. En: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; March 20, 2024. Disponible en: https://www.ncbi.nlm.nih.gov/books/NBK559060

20. Tekin HG, Skyum H, Spaun E, et al. Lichen sclerosus-associated nevus on glans penis mimicking melanoma. JAAD Case Rep. 2020;6(4):323-325. doi: 10.1016/j.jdcr.2020.02.017

21. Natsis NE, Gordon SC, Kaushik A, et al. A practical review of dermoscopy for pediatric dermatology part II: Vascular tumors, infections, and inflammatory dermatoses. Pediatr Dermatol. 2020;37(5):798-803. doi: 10.1111/pde.14284. Erratum in: Pediatr Dermatol. 2021;38(3):738-739. doi: 10.1111/pde.14568

22. Ferreira I, Kind P, Van Den Berghe I, et al. Melanocytic naevi with perineurial differentiation: a distinctive variant of neurotised naevi and a diagnostic pitfall with desmoplastic melanoma. Histopathology. 2018;72(4):679-84. doi: 10.1111/his.13418

23. Chen L, Wang Y, Zhang W, et al. Preliminary evaluation of penile papule dermatoses with reflectance confocal microscopy in children. Skin Res Technol. 2023;29(4):e13330. doi: 10.1111/srt.13330

24. Teichgräber F, Jacob L, Koyanagi A, et al. Association between skin disorders and depression in children and adolescents: A retrospective case-control study. J Affect Disord. 2021 1;282:939-44. doi: 10.1016/j.jad.2021.01.002

25. Paller AS, Rangel SM, Chamlin SL, et al. Stigmatization and Mental Health Impact of Chronic Pediatric Skin Disorders. JAMA Dermatol. 2024;160(6):621-30. doi: 10.1001/jamadermatol.2024.0594

26. Jafry MA, Peacock S, Radick AC, et al. Pathologists' agreement on treatment suggestions for melanocytic skin lesions. J Am Acad Dermatol. 2020;82(6):1435-44. doi: 10.1016/j.jaad.2019.12.020

27. Marín-Hernández E, Rivera-Salgado IM, Marín-González EJ. Mácula melanótica del pene. Reporte de tres casos. Dermatología Cosmética, Médica y Quirúrgica. 2020;18(4):250-4. Disponible en https://www.medigraphic.com/pdfs/cosmetica/dcm-2020/dcm204b.pdf

28. Mendes CP, Samorano LP, Alessi SS, et al. Divided naevus of the penis: two paediatric cases with dermoscopic findings. Clin Exp Dermatol. 2014:39(6):728-30. doi: 10.1111/ced.12397

29. Rocco T, Ventura A, Ciciarelli V, et al. Pigmented lesions with unusual penile localisation: Usefulness of reflectance confocal microscopy - Report of 2 cases. Australas J Dermatol. 2021;62(3):e456-8. doi: 10.1111/ajd.13615

30. Donnenfeld SR, Lovin JM, Santore MT, et al. Giant Congenital Melanocytic Nevus of the Male External Genitalia: A Pediatric Case Report of Diagnosis, Evaluation and Management. Urology. 2023;181:147-9. doi: 10.1016/j.urology.2023.08.004

31. Correia B, Duarte AF, Haneke E, et al. CO2 laser treatment of a kissing nevus of the penis: an alternative solution for a rare condition. J Dermatolog Treat. 2021;32(1):120-3. doi: 10.1080/09546634.2019.1629384