Related Experiment Video
Updated: May 16, 2026
Anterior High-Resolution Optical Coherence Tomography in the Diagnosis and Therapeutic Monitoring of Ocular Surface Squamous Neoplasia
Published on: August 9, 2024
[Indication for early excision of the giant congenital nevus]
J C López Gutiérrez1, M García Palacios, Mercedes Díaz
1Servicio de Cirugía Pediátrica, Sección de Cirugía Plástica, Hospital Universitario La Paz, Madrid. queminfantil.hulp@salud.madrid.org
Insights
Early surgical removal of giant congenital nevi (GCN) can benefit selected children and their families, improving cosmetic outcomes and reducing psychosocial distress, despite a lack of international consensus on timing.
Area of Science:
- Dermatology
- Pediatric Surgery
Context:
- Giant congenital nevi (GCN) management remains controversial regarding prophylactic removal.
- While melanoma risk is debated, early intervention offers patient benefits.
Purpose:
- To evaluate the outcomes of early surgical removal of GCN in infants.
- To assess cosmetic results, functional impact, and psychosocial effects.
Summary:
- 41 children underwent early excision of melanocytic lesions within the first year of life.
- Indications included pain, bleeding, alarming dermatoscopic changes, scalp location, and parental distress.
- Primary closure was used for scalp lesions (3-5 cm) to avoid future interventions.
Impact:
- Early surgery yielded good cosmetic results and improved familial psychosocial well-being.
- No disturbances in scholar activities were observed post-surgery.
- This study supports selective early surgical intervention for GCN in infants.
Introduction:
Most of specialists involved in giant congenital nevi (GCN) care, agree that the risk of melanoma is probably not significant enough to warrant the prophylactic removal of all those lesions. However, many patients benefit from very early surgical procedures.
Material And Methods:
In the last 15 years 41 children undergwent surgical removal of their large or giant melanocityc lesions in the first year of life at our institution. Indications for such an early excision were as follows: painful ulceration or bleeding, alarming dermatoscopic changes, location in the scalp being removable with primary closure, concomitant surgical procedures, multiple expected interventions and severe parental psychosocial distress.
Results:
All patients had a good cosmetic result. All nevus in the scalp between 3 and 5 cms were removed with a primary closure in order to avoid future need of scalp expansion. Familial psychological distress improved significantly and disturbances related to scholar activities were not noticed.
Conclusions:
Despite the lack of international consensus regarding the appropriate timing for large or giant congenital nevi excision, a selection of patients and their families can benefit from early surgical removal.
