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Neurocristic hamartomas (NCHs), proliferations of melanocytes; Schwann cells; and pigmented, spindled, and dendritic blue nevus cells, are very rarely malignant. These authors review the clinicopathologic presentation of malignant NCH in three patients (median age, 30; two women) who presented with malignant NCH over a 23-year period at one tertiary care center, two of whom developed lymph node metastasis.
The clinical presentations were of scalp masses (average dimension, 1.5 cm) occurring against a background of a brown-bluish plaque (average largest dimension, 7 cm). NCHs consisted of dendritic melanocytes extending to the subcutis, with areas of blue nevus-like and cellular-blue nevus–like growth pattern. Aggressive behavior was associat…