DOI: https://doi.org/10.36347/sasjm.2025.v11i09.017

Pages: 912-916

Giant congenital nevus (GCN) is a rare, benign pigmented lesion present at birth, with an estimated incidence of 0.2 to 2.1 per 10,000 live births. Although benign, it carries a risk of malignant transformation, particularly into melanoma, and may involve the central nervous system, leading to neurocutaneous melanosis. Beyond medical risks, GCN presents significant psychosocial and surgical challenges, especially in resource-limited settings. This study reports a ten-year clinical experience in managing GCN at Rabat Children’s Hospital, evaluates outcomes associated with different surgical techniques, and proposes a practical treatment algorithm suitable for low-resource environments. A retrospective descriptive analysis was conducted from April 2012 to August 2022 in the Plastic Surgery Unit, including 26 pediatric patients with congenital nevi of varying sizes and locations. Demographic data, clinical presentation, surgical interventions, hospital stay, and postoperative outcomes were analyzed, with photographic documentation and independent verification ensuring reliability. Among the patients (62% female; mean age 7.8 years), 54% had giant nevi, most frequently located on the face (62%). Surgical management included simple excision (11.5%), iterative excision (26.9%), total or partial skin grafting (50%), and tissue expansion (11.5%). No cases of melanoma or neurocutaneous melanosis were observed. Postoperative complications were minimal, with 7.7% experiencing partial graft loss and 11.5% developing retractile scarring. Treatment decisions were tailored to lesion characteristics and patients’ socioeconomic context. These findings underscore the clinical and psychosocial burden of GCN and highlight the importance of a flexible, patient-centered approach in resource-constrained settings. While advanced techniques such as tissue expansion provide superior cosmetic outcomes, simpler methods like excision with grafting remain effective and accessible. Given the smal