A retrospective multicenter study of fatal pediatric melanoma.

BACKGROUND

Pediatric melanoma is rare and diagnostically challenging.

OBJECTIVE

To characterize clinical and histopathologic features of fatal pediatric melanomas.

METHODS

Multicenter retrospective study of fatal melanoma cases in patients younger than 20 years diagnosed between 1994 and 2017.

RESULTS

Of 38 cases of fatal pediatric melanoma identified, 57% presented in white patients and 19% in Hispanic patients. The average age at diagnosis was 12.7 years (range, 0.0-19.9 y), and the average age at death was 15.6 years (range, 1.2-26.2 y). Among cases with known identifiable subtypes, 50% were nodular (8/16), 31% were superficial spreading (5/16), and 19% were spitzoid melanoma (3/16). One fourth (10/38) of melanomas arose in association with congenital melanocytic nevi.

LIMITATIONS

Retrospective nature, cohort size, and potential referral bias.

CONCLUSIONS

Pediatric melanoma can be fatal in diverse clinical presentations, including a striking prevalence of Hispanic patients compared to adult disease, and with a range of clinical subtypes, although no fatal cases of spitzoid melanoma were diagnosed during childhood.