Pathologic Features of 43 Cases

NForty-three cases of melanoma occurring before age 20 years were reviewed from a twenty-one year period at a single center. Thirteen of the patients were preadolescent children, and 90 % were Caucasian. Histologic review of 39 available primary tumors showed superficial spreading and nodular types only. Thickness ranged from 0.23 mm to 5.43 mn, with a mean of 1.58 mm. Ulceration was present in 8%, necrosis in 28%, evidence of regression in 21%, and antecedent nevus in 33 % of cases. The overall 5 year survival is 79%, with a median follow-up of 42 months. There is no detectable survival difference between preadolescent children and adolescents. Several treatment failures occurred after improper biopsy and/or inaccurate original diagnosis of Spitz's nevus. Of 34 Stage I and II patients given definitive surgical treatment by the authors, the 5 year survival is 95%. Although histologic confusion with Spitz's nevi occasionally occurs, melanoma in this age group can be treated with good results.