Screening Children Part 3 Melanoma

Question 1

3 categories of melanoma in paediatric population

Answer 1

De Novo - SSM + spitzoid melanoma

Associated with nevus - congenital

Question 2

Percentage melanoma De Novo vs on CMN: Adult

Answer 2

70 vs 30

Question 3

Percentage melanoma De Novo vs on CMN: Children

Answer 3

45 vs 55

Question 4

Melanoma in children: Mortality

Answer 4

28%

Question 5

Prognosis Melanoma on CMN vs De Novo

Reasons

Answer 5

Prognosis worse with CMN associated melanoma
Some of melanomas arising De Novo are spitzoid and they have better prognosis wrt death although risks of Mets similar to nodular melanoma.
At least some of the lesions diagnosed as melanoma were spitz nevi.

Question 6

3 biological patterns of paediatric melanoma

Answer 6

SSM, mainly arising > 10 years, associated with acquired nevus 25% cases, biological behaviour similar to adulthood.
Nodular melanoma, arising early childhood, associated congenital nevus 1/3 cases, more aggressive behaviour.
Spitzoid melanoma, mainly DNM, < 10, higher Breslin thickness and more nodal involvement, but more indolent behaviour and better prognosis.