Contents
pdf Download PDF pdf Download XML
7 Views
2 Downloads
Share this article
Research Article | Volume 19 Issue 3 (Jul, 2026) | Pages 128 - 136
WNT-activated deep penetrating melanocytoma arising within a congenital melanocytic nevus in a pediatric patient: a case report
 ,
 ,
 ,
1
MS IV, USD Sanford School of Medicine, ORCID iD 0009-0004-7306-9145
2
MD, PGY-3, USD Sanford School of Medicine
3
MD, Sanford Pathology Clinic, USD Sanford School of Medicine
4
MD, Sanford Dermatology Clinic, USD Sanford School of Medicine, ORCID iD 0009-0006-1067-8378
Under a Creative Commons license
Open Access
Received
Aug. 26, 2026
Revised
Sept. 11, 2026
Accepted
Sept. 14, 2026
Published
Sept. 26, 2026
Abstract

Deep penetrating melanocytoma is an uncommon melanocytic tumor characterized by activation of the WNT/β-catenin pathway and can present a diagnostic challenge because of histologic overlap with melanoma and other melanocytic neoplasms. We report a case of WNT-activated deep penetrating melanocytoma arising within a superficial congenital-pattern melanocytic nevus in a 16-year-old male. A slowly darkening, pigmented papule on the left parietal scalp was initially biopsied locally and demonstrated a biphasic compound melanocytic proliferation with a superficial congenital-pattern component and a deeper nested population of pigmented melanocytes. Histopathologic features included rare dermal mitoses, superficial dermal fibrosis, scattered melanophages, and abundant lymphohistiocytic inflammation. Immunohistochemical studies demonstrated MART-1 expression, focal HMB-45 staining, mosaic p16 expression, negative PRAME staining, and nuclear β-catenin staining within the larger central melanocytes. Expert dermatopathology consultation favored a low-grade WNT-activated deep penetrating melanocytoma arising within the congenital-pattern nevus. The lesion extended focally to the specimen base following conservative excision, and close clinical surveillance was selected. This case highlights the importance of recognizing the characteristic biphasic architecture and immunophenotypic features of WNT-activated melanocytoma, particularly when arising within a conventional melanocytic nevus in a pediatric patient. Accurate distinction from melanoma and other melanocytic mimics can help guide appropriate management and avoid unnecessarily aggressive treatment.

Keywords
Recommended Articles
Research Article
Coexistence of Psoriasis and Alopecia Universalis: A Rare Clinical Association
...
Published: 26/09/2026
Case Report
Pellagra-like presentation of borderline tuberculoid Hansen disease with a Type 1 lepra reaction: a diagnostic mimic
Published: 18/09/2026
Research Article
Analgesic Efficacy of Pericapsular Nerve Group Block versus Femoral Nerve Block before Spinal Anaesthesia for Hip Surgery: A Randomized Trial
Published: 08/08/2024
Research Article
Antibiotic susceptibility pattern of Extended-spectrum Beta-lactamase-producing Escherichia coli and Klebsiella pneumoniae isolated from indoor patients of SRG Hospital, Jhalawar
...
Published: 04/06/2025
© Copyright Spejalisci Dermatolodzy