Pigmented skin neoplasm in a child: сomplex case report and review of the literature

T.  S. Belysheva; Белышева Т. С.; T.  V. Nasedkina; Наседкина Т.  В.; K. V. Orlova; Орлова К.  В.; Y. V. Vishnevskaya; Вишневская Я. В.; I. S. Kletskaya; Клецкая И. С.; D. B. Khestanov; Хестанов Д.  Б.; M. B. Doroshenko; Дорошенко М. Б.; S. N. Mikhaylova; Михайлова С. Н.; A.  I. Senderovich; Сендерович А.  И.; M. A. Emelyanova; Емельянова М. А.; I. S. Abramov; Абрамов И. С.; L. V. Demidov; Демидов Л. В.; M. D. Aliev; Алиев М. Д.

doi:10.17650/2070-9781-2020-21-3-16-25

Pigmented skin neoplasm in a child: сomplex case report and review of the literature

Authors: Belysheva T..¹, Nasedkina T..², Orlova K.V.¹, Vishnevskaya Y.V.¹, Kletskaya I.S.³, Khestanov D.B.¹, Doroshenko M.B.¹, Mikhaylova S.N.¹, Senderovich A..⁴, Emelyanova M.A.², Abramov I.S.², Demidov L.V.¹, Aliev M.D.⁵
Affiliations:
1. N.N. Blokhin National Medical Research Center of Oncology of the Ministry of Health of the Russian Federation
2. Engelhardt Institute of Molecular Biology of the Russian Academy of Sciences
3. Russian Children’s Clinical Hospital of Pirogov Russian National Research Medical University of the Ministry of Health of the Russian Federation
4. The Federal State Budgetary Institution “Central clinical hospital with polyclinic” of the Administrative Department of the President of the Russian Federation
5. National Medical Research Radiological Center of the Ministry of Health of the Russian Federation
Issue: Vol 12, No 2-3 (2020)
Pages: 16-25
Section: TUMORS OF THE SKIN
Published: 05.07.2020
URL: https://sarbon.abvpress.ru/jour/article/view/4
DOI: https://doi.org/10.17650/2070-9781-2020-21-3-16-25
ID: 4

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Abstract

Introduction. Skin melanoma in children is a very rare disease that differs in many aspects from skin melanoma in adults. The conventional criteria for clinical diagnostics of melanoma observed in adults are often absent in children and adolescents, making it difficult to make a diagnosis on time.

Objective. The aim of the study is to assess the clinical significance of various diagnostic criteria in the analysis of a rare case of congenital pigment skin neoplasm in a child.

Materials and methods. The clinical case of a congenital melanocytic lesion in a wrist joint area in a girl 5 months old.

During the primary diagnosis, an ultrasound examination was carried out. The tumor excision was performed with replacement of defect using moved skin flap. Histological, genetic and cytogenetic (fluorescent hybridization in situ, FISH) examination of a tumor sample was carried out.

Results. The histological examination revealed areas of cellular atypia with high mitotic activity and the presence of pathological mitoses. According to FISH results, an increase in the copy of the RREB1 gene was observed in the sample, which may indicate amplification of this chromosome region. Genetic testing revealed a Q61K mutation in the NRAS gene.

Conclusion. Despite the presence of histological features of neoplasm malignancy and ambiguous FISH results, the described case should be considered as congenital nevus with atypical proliferative nodes based on combination of clinical data (early age at the time of surgery, expansive growth pattern, multiplicity of nodes, lack of necrosis, long relapse-free period).

Keywords

melanoma, children, proliferating node, congenital nevus

About the authors

T. S. Belysheva

N.N. Blokhin National Medical Research Center of Oncology of the Ministry of Health of the Russian Federation

Author for correspondence.
ORCID iD: 0000-0001-5911-553X

24 Kashirskoe Shosse, Moscow 115478

Russian Federation

T. V. Nasedkina

Engelhardt Institute of Molecular Biology of the Russian Academy of Sciences

ORCID iD: 0000-0002-2642-4202

32 Vavilov St., Moscow, 119991

Russian Federation

K. V. Orlova

N.N. Blokhin National Medical Research Center of Oncology of the Ministry of Health of the Russian Federation

ORCID iD: 0000-0002-0442-5917

24 Kashirskoe Shosse, Moscow 115478

Russian Federation

Y. V. Vishnevskaya

N.N. Blokhin National Medical Research Center of Oncology of the Ministry of Health of the Russian Federation

ORCID iD: 0000-0002-4066-179X

24 Kashirskoe Shosse, Moscow 115478

Russian Federation

I. S. Kletskaya

Russian Children’s Clinical Hospital of Pirogov Russian National Research Medical University of the Ministry of Health of the Russian Federation

ORCID iD: 0000-0002-8552-7682

117 Leninsky prosp., Moscow 119571

Russian Federation

D. B. Khestanov

N.N. Blokhin National Medical Research Center of Oncology of the Ministry of Health of the Russian Federation

ORCID iD: 0000-0002-8149-254X

24 Kashirskoe Shosse, Moscow 115478

Russian Federation

M. B. Doroshenko

N.N. Blokhin National Medical Research Center of Oncology of the Ministry of Health of the Russian Federation

ORCID iD: 0000-0002-5400-4539

24 Kashirskoe Shosse, Moscow 115478

Russian Federation

S. N. Mikhaylova

N.N. Blokhin National Medical Research Center of Oncology of the Ministry of Health of the Russian Federation

ORCID iD: 0000-0002-9502-072X

24 Kashirskoe Shosse, Moscow 115478

Russian Federation

A. I. Senderovich

The Federal State Budgetary Institution “Central clinical hospital with polyclinic” of the Administrative Department of the President of the Russian Federation

ORCID iD: 0000-0003-2213-5785

15 Marshal Tymoshenko St., 121359 Moscow

Russian Federation