New Data Improve Characterization of Pediatric Melanoma

Data from several recently published studies have shed new light on the behavior and natural history of melanoma in children and adolescents – and much of the news is good, according to Dr. Sheilagh M. Maguiness.
For example, the findings suggest that the risk of malignant melanoma arising in large congenital nevi is lower than previously thought, at about 2%. Also, outside of the neonatal period, the prognosis is excellent for most children diagnosed with melanoma, said Dr. Maguiness of Boston Children’s Hospital.
Data from three of the studies, taken together, show that 36 deaths occurred in 278 cases involving melanoma during childhood or adolescence, for a mortality rate of 13%.
“There was only one death in a child under 10, and that was in the setting of a large congenital nevus,” she said at the annual meeting of the American Academy of Dermatology.
Furthermore, the presentation of melanoma in adolescents is similar to that in adults, and the outcomes seem to parallel – and perhaps exceed – those of adults with similar stage tumors, she noted.
The studies do little, however, to clear up controversy about the value of sentinel lymph node biopsy for predicting outcomes in children with melanoma, she said.
Pediatric melanoma represents only about 1%-3% of all melanomas and about 2% of all pediatric malignancies, and it is best considered based on the timing of presentation – presentation during the congenital period, during childhood up to the age of 10 years, and during adolescence – because findings during these stages differ substantially, she said.
Melanoma during the congenital and neonatal period is extremely rare. Four cases involving transplacental metastases from maternal malignant melanoma, nine cases involving large or giant congenital melanocytic nevi, and seven de novo cases have been

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