Case Number : Case 1552 - 07 June Posted By: Guest

Looks like blue nevus but the limits are compromised so should state it to get a full excision (for complete evaluation), these lesions can recur and be quite deep, particularly in that location

Cellular blue naevus, which would correlate with the site. 

cellular blue nevus

Would favour a cellular blue naevus, typical site.

Cellular blue naevus.

There is clearly a spindle/dendritic melanocytic component, which puts the lesion more in the blue naevus category than DPN…I think.

Periadnexal spread is a feature of both.

Cellular blue nevus.

Blue nevus.

Incomplete shave biopsy of BN.

I called this a cellular blue nevus and asked for a complete excision. This lesion addresses the difficulty of separating blue nevi that are on the cellular end of things and the so-called cellular blue nevus. I have had some issues with clinicians misinterpreting these lesions as benign (with a local recurrence rate of zero), so have called these cellular blue nevi to facilitate a re excision.  Dermal dendritic melanocytes characterize these lesions, but plenty of overlap among CBN, DPN and pigmented Spitz nevi that are not as epithelioid.

Great discussion!

Uma,  I'm slightly confused.  Cellular blue naevi are benign and any benign tumour incompletely excised may recur locally (but not always). What is the reason for recommending re-excision - are you concerned for example the lesion may have a risk for malignant transformation or that the diagnosis is not 100% certain and you would rather see it completely excised with clear margins for that reason - analogous to Spitz tumours?