title: Malignant melanoma arising in a pregnant African American woman with a congenital blue nevus.
abstract: BACKGROUND
  The incidence of cutaneous melanoma in African-Americans is relatively low. Despite the slightly greater occurrence of congenital melanocytic nevi in black persons compared with white persons, the cumulative risk of melanoma arising in these lesions is very small. In addition, the overwhelming majority of melanomas in black persons occur on nonglaborous skin where congenital melanocytic nevi are rare.
  
  
  OBJECTIVE
  The objective was to describe and an unusual case of melanoma arising in a congenital nevus with combined features of a blue nevus on the scalp of a pregnant African-American woman.
  
  
  RESULTS
  Histologic examination revealed a polypoid malignant melanoma arising in association with a congenital blue nevus in a young African-American woman. The lesion was located on the right parietal scalp and had been enlarging over the course of her pregnancy. Pathology from parotidectomy and neck dissection confirmed metastatic melanoma involving two intraparotid lymph nodes and 3 of 26 cervical lymph nodes. Despite aggressive chemotherapy, she died in 1 year after the diagnosis.
  
  
  METHODS
  A case is reported and the literature is reviewed.
  
  
  CONCLUSIONS
  Clinicians must take great care in documenting and following pigmented lesions in all patients including African-American persons. Excision is indicated for lesions that undergo significant change during pregnancy.
authors.affiliation: Department of Dermatology, MetroHealth Medical Center, Case Western Reserve University, Cleveland, Ohio 44109-1998, USA. sweimin@yahoo.com
authors.forename: Weimin
authors.initials: W
authors.lastname: Hu
authors.forename: Jennell E
authors.initials: JE
authors.lastname: Nelson
authors.forename: Craig A
authors.initials: CA
authors.lastname: Mohney
authors.forename: Marlene D
authors.initials: MD
authors.lastname: Willen
mesh_terms: D000328:Adult; D003937:Diagnosis, Differential; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D008545:Melanoma / Q000175:diagnosis* / Q000209:etiology / Q000473:pathology / Q000601:surgery; D018329:Nevus, Blue / Q000150:complications / Q000151:congenital* / Q000473:pathology; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic / Q000175:diagnosis* / Q000209:etiology / Q000473:pathology; D012535:Scalp; D012878:Skin Neoplasms / Q000175:diagnosis* / Q000209:etiology / Q000473:pathology / Q000601:surgery