Malignant melanoma of childhood.A clinicopathologic study and a report of 12 cases

Abstract

Twelve cases of malignant melanoma of childhood were collected from the pathology files of Memorial and James Ewing Hospitals covering a 40‐year period from 1928 to 1968. All of these cases had documented evidence of metastatic disease; 4 have survived longer than 5 years, and 2 of these are alive and well more than 15 years after therapeutic regional lymph node dissection. Clinical and pathologic findings in these cases are summarized, and a brief historical review is included.

Congenital giant pigmented nevi: Clinical features and risk of malignancy

“…It has been stated that one third of childhood melanoma arise from CGPN (11). This study, as well as other studies in the literature (25)(26)(27)(28), did not confirm this statement (Table 5). Using questionnaires, Ontario Cancer Registry data and a retrospective clinical review, only a single case of malignant melanoma arising from CGPN was identified during the past 15 years in Ontario, indicating the rarity of this condition.…”

Cutaneous malignant melanoma in children

“…These nevi follow a benign course, thus encouraging the misconception of a benign evolution of malignant melanoma in children. Malignant melanoma in children is capable of metastasis and may follow an aggressive pattern [4]. The connection between adult risk factors such as inability to tan or suering sunburn accompanied by blisters on the one hand and the development of childhood malignant melanoma on the other has not been proven [11].…”

Malignant Melanoma in Children

“…Most cases have been reported in adults, but cases in young chil¬ dren have been documented. 16,73,74 Although melano¬ mas may arise de novo, they are more commonly asso¬ ciated with a precursor cellular blue nevus, which may be congenital (Figure 9). Because of the rarity of the event and the small number of published cases, the rate of malignant transformation of cellular blue nevi is un¬ known.74 Nevus spilus is a light brown-pigmented, circum¬ scribed macule in which darker-pigmented, raised or flat, lentigolike elements are present (Figure I O).…”

“…12,16,29,37,73,117 Currently, the same ex¬ cision margin criteria used for MM in adults are applied to childhood MM.12,39 Clinically suspected regional lymph nodes should also be removed.29,39,73 Regional lymph node dissection in the absence of clinically involved nodes re¬ mains controversial. 29,39,73,117'119 Besides surgery, the main alternative therapeutic meth¬ ods for MM include chemotherapy, radiotherapy, and im¬ munotherapy.…”

“…8,18,73,117,127 Congenital MM origi¬ nating in transplacental métastases from a maternal primary lesion carries a very poor prognosis because of multiorgan involvement, whereas the prognosis for de novo congen¬ ital melanoma may be better than expected.128 Malignant melanomas arising in patients with GCMN also have been considered to carry a poor prognosis, probably due to the difficulties surrounding early diagnosis.117 The depth of invasion of the primary tumor corre¬ lates well with the patient's prognosis,12,30,37,73,129"131 hence the importance of early diagnosis. In our review, recur¬ rences after initial treatment and timing of initial recur¬ rence tended to be different in children than in adults.…”