Background: Pediatric malignant melanoma (MM) is categorized by the age as congenital, childhood and adolescent subtypes. Congenital melanoma is present at birth or in the first year of life. It is an exceedingly rare entity for the low incidence and difficult diagnosis. Here, we present two cases of congenital malignant melanoma. Besides, we describe the special clinicopathologic and molecular features of pediatric MM especially congenital sub-type by reviewing the literature. Case presentation: We report two cases of congenital malignant melanoma. One is a boy patient who had been born with a mass in the occipital scalp, the other newborn girl presented with a mass at birth on her right shoulder. Two patients all underwent the excision of the nodular lesion. Histological evaluation revealed the boy case is pigmented epithelioid melanocytoma (PEM), a unique low-grade variant of malignant melanoma of the skin. The other is congenital melanoma. After the operation, the boy patient presented with cervical lymph node metastasis on the third postoperative month, but is still alive and is developing well. The girl patient recovered, with no recurrence or metastasis since follow-up.Conclusions: Congenital melanoma is a rare sub-type of pediatric melanoma. Accurate diagnosis of congenital MM is challenging and requires the combination of clinical presentation, pathologic and molecular findings. The cases we offered will contribute to the understanding of epidemiological features and molecular biology of congenital MM and pediatric MM.
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