Combination of preoperative embolization and surgery in the treatment of a giant congenital neuroid nevus of the forehead and scalp in a child. Case report

• Published in: Journal of neurosurgery. Pediatrics Vol. 3; no. 3; p. 215
• Main Authors: Margulis, Alexander, Koplewitz, Benjamin Z, Maly, Alexander, Cohen, José, Yanko-Arzi, Ravit, Gomori, John M, Neuman, Rami
• Format: Journal Article
• Language: English
• Published: United States 01.03.2009
• Subjects: Embolization, Therapeutic; Facial Neoplasms - congenital; Facial Neoplasms - pathology; Facial Neoplasms - therapy; Forehead; Humans; Infant, Newborn; Male; Nevus, Pigmented - congenital; Nevus, Pigmented - pathology; Nevus, Pigmented - therapy; Scalp; Skin Neoplasms - congenital; Skin Neoplasms - pathology; Skin Neoplasms - therapy
• ISSN: 1933-0707
• DOI: 10.3171/2008.11.PEDS08146

Congenital melanocytic nevi of neuroectodermal origin are composed primarily of melanocytes and occasional neural elements. A subset of large/giant congenital melanocytic nevi is characterized by neuroidal differentiation resembling the histological pattern of neurofibroma (neuroid congenital melanocytic nevi). The authors report the case of a male infant born with a neuroid congenital melanocytic nevus presenting as a large mass covering extensive portions of his scalp and forehead. The atypical feeding arteries to the nevus were larger in diameter then the patient's internal carotid arteries and formed a rich network of large blood vessels in the nevus. Selective preoperative embolization using calibrated particles was followed by a complete excision and staged reconstruction with tissue expanders. The authors believe that this multidisciplinary approach allowed for a safe surgical procedure with minimal blood loss for this most unusual pediatric head and neck tumor.