Malignant melanoma in childhood

Six cases of malignant melanoma in children 14 years of age and younger are reported. The six cases were diagnosed among 850,000 consecutive skin biopsy specimens and consultation slides examined within a 32-year period. This series included an infant born with neurocutaneous melanosis, a child with malignant melanoma developing in a large congenital nevus at the age of 13 years, a superficial spreading malignant melanoma, Clark Level III, in a child with many dysplastic nevi, and three cases with primary nodular malignant melanoma, two of which showed histologic features of Spitz nevus. A review of the literature indicates that malignant melanoma in childhood is rare, and no large series have been investigated. It is not known whether the genetic and the environmental factors incriminated in the development of malignant melanoma in adults play a role in childhood melanomas. Data on the incidence of childhood melanoma in the population, the clinical and the histologic variations, and the prognosis are not adequate. A multiinstitutional study is needed to gather a large enough series to provide this information.