The aim of this study was to evaluate Nodal expression in pediatric LCMN and correlate this with patient data, including melanoma history, to determine clinical relevancy of Nodal in LCMN patients at high risk for melanoma and explore specific LCMN characteristics that could negatively affect Nodal function and potential melanomagenesis in LCMN patients with low risk for melanoma. Here, NODAL is linked to large congenital melanocytic nevus.