PEDIATRICS Vol. 55 No. 2 February 1975, pp. 191-204
This Article
Right arrow Full Text (PDF)
Right arrow P3Rs: Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when P3Rs are posted
Right arrow Alert me if a correction is posted
Services
Right arrow E-mail this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My File Cabinet
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via CrossRef
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Trozak, D. J.
Right arrow Articles by Hu, F.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Trozak, D. J.
Right arrow Articles by Hu, F.

Metastatic Malignant Melanoma in Prepubertal Children

Daniel J. Trozak M.D.1, Willard D. Rowland M.D.1, and Funan Hu M.D.1

1 Department of Dermatology, University of Oregon Medical School, and the Department of Plastic Surgery, Good Samaritan Hospital, Portland, Oregon, and the Oregon Regional Primate Research Center, Beaverton, Oregon

Medical literature is full of involved and Confusing reports on the genesis, incidence, and development of metastatic melanoma in children. The reason for this confusion can be found in the early uncertainties that surrounded the real nature and correct diagnosis of metastatic melanoma in the prepubertal child. Before 1950, reports of melanomas with metastases in children were rare, poorly documented, and in many cases erroneous.1-4 In particular, benign nevi (now known as benign juvenile melanoma) went unrecognized and because of their alarming microscopic features were often diagnosed as malignant melanomas. For example, deceived by the predilection of this nevus for childhood, its frightening appearance, and failure to metastasize, Pack and Anglem wrote: ". . . . although malignant melanomas are found in infancy and childhood, they are of low grade malignancy and seldom metastasize" In a later paper, Pack6 coined the term "prepubertal melanoma" for those nonmetastasizing pigmented tumors of children which were microscopically indistinguishable from melanoma. He suggested removal before puberty when endocrinologic stimulation rendered certain of them capable of metastasis. Other investigators also noted this seeming disparity between microscopic appearance and clinical behavior.7 In 1948, Spitz8 provided the criteria for separating this unusual-looking nevus from malignant melanoma and termed it "juvenile melanoma." Later she and Allen9 showed that although these lesions are not restricted to children, they are much more common before puberty.* Subsequent authors10-13 have also classified juvenile melanoma among the benign nevi and the term spindle or epithelioid cell nevus10,12,13 is now preferred. McWhorter and Woolner13 in 1954 reviewed the subject of malignant melanoma in children and suggested that the favorable prognosis was spurious and due to the erroneous classification of spindle and epithelioid cell nevi under the former agnosis.

Submitted on November 15, 1973
Accepted on May 7, 1964




This article has been cited by other articles:


Home page
 Arch DermatolHome page
S. N. Leech, H. Bell, N. Leonard, S. L. Jones, D. Geurin, P. H. McKee, and C. M. Lawrence
Neonatal Giant Congenital Nevi With Proliferative Nodules: A Clinicopathologic Study and Literature Review of Neonatal Melanoma
Arch Dermatol, January 1, 2004; 140(1): 83 - 88.
[Abstract] [Full Text] [PDF]

Home page
 CLIN PEDIATRHome page
N. M. Bajwa, E. N. Mostow, and R. M. Schwartz
Rapidly Expanding Lesion in a Giant Congenital Melanocytic Nevus
Clinical Pediatrics, June 1, 2003; 42(5): 455 - 458.
[PDF]

Home page
 Arch DermatolHome page
J. Wechsler, S. Bastuji-Garin, A. Spatz, C. Bailly, B. Cribier, L. Andrac-Meyer, B. Vergier, S. Fraitag, O. Verola, P. Wolkenstein, et al.
Reliability of the Histopathologic Diagnosis of Malignant Melanoma in Childhood
Arch Dermatol, May 1, 2002; 138(5): 625 - 628.
[Abstract] [Full Text] [PDF]

Home page
 NEJMHome page
P. I. Ceballos, R. Ruiz-Maldonado, and M. C. Mihm
Melanoma in Children
N. Engl. J. Med., March 9, 1995; 332(10): 656 - 662.
[Full Text] [PDF]