Malignant melanoma in childhood and adolescence

In this review, the epidemiology and prognosis of malignant melanoma in childhood and adolescence (CMM) are discussed with reference to 627 patients reported in the literature. CMM accounts for only 1-2% of all melanomas, but there is the same increasing incidence as in adult melanoma. A distinction is made between congenital CMM (n = 27), CMM on giant congenital pigmented naevi (n = 69) and CMM in small pigmented lesions or de novo. The latter are identical in biological behaviour to melanomas in adults, while the CMM on giant naevi nearly always have an unfavourable outcome. Chemotherapy seems to be more effective in CMM than in adult melanomas, but prophylaxis is also the best therapy in children: early removal of congenital giant pigmented naevi and frequent monitoring, if not excision, of all congenital melanocytic lesions must be considered.