case_images: PMC11334130_01
case_images: A woman in her early 20s presented with a huge congenital nevus in the backside of upper trunk.
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case_images: The lesion measured 36 cm horizontally and 54 cm vertically, with significant pigmentation visible to the naked eye, raising clinical suspicion of a GCMN (Figure 1). To confirm the diagnosis and rule out malignancy, a biopsy via fine-needle aspiration was performed.
case_images: Histopathology staining of the nevus: Hematoxylin-Eosin staining ((a) and (b)) and S100 Immunohistochemistry staining ((c) and (d)). (a) Nest of melanocytes in the dermis with melanin pigments around the cells. (b) Melanocytes in the dermis with round shape and scant cytoplasm (arrow). Melanin pigments can be seen around the cells (arrowhead). (c) Nest of melanocytes in the dermis showed positive with S100 (arrow). (d) Melanocytes in the dermis showed cytoplasmic and nuclear staining with S100 marker (arrow). Scale bars represent 100 mum. Low to high magnification by optical microscopy: ((a) and (c)) 100x, ((b) and (d)) 400x.
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case_images: After meticulous dissection, the nevus was partially resected, and pathology confirmed a compound congenital nevus with extensive subcutaneous involvement (Figure 2).
case_images: First tissue expansion. (a) Two tissue expanders were inserted on both sides to the border of the giant nevus. ((b)-(d)) Full expansion of the first two tissue expanders.
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case_images: Each expander was inflated to 600 mL over 10 weeks (Figure 3).
case_images: Second-stage operation two tissue expanders removal and partial resection of giant nevus. (a) Preoperative design. (b) Two tissue expanders were removed. (c) Postoperative imaging.
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case_images: Over half of the nevus was excised and resurfaced with the expanded flaps (Figure 4).
case_images: (a) Full expansion of the second tissue expander. (b) Postoperative of the second tissue expander removal and total resection of giant nevus. (c) Final postoperative a year follow-up.
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case_images: Satisfactory outcomes were observed during a 1-year postoperative follow-up (Figure 5).