Juvenile melanoma

Author:Prof. Dr. med. Peter Altmeyer

All authors of this article

Last updated on: 27.09.2023

Dieser Artikel auf Deutsch

Synonym(s)

Juveniles malignant melanoma; Malignant melanoma in childhood; Malignant melanoma in young people; Melanoma in adolescents; Melanoma in children

Requires free registration (medical professionals only)

Please login to access all articles, images, and functions.

Our content is available exclusively to medical professionals. If you have already registered, please login. If you haven't, you can register for free (medical professionals only).


Requires free registration (medical professionals only)

Please complete your registration to access all articles and images.

To gain access, you must complete your registration. You either haven't confirmed your e-mail address or we still need proof that you are a member of the medical profession.

Finish your registration now

DefinitionThis section has been translated automatically.

Rare melanocytic tumour, usually developing de novo in children and adolescents. However, current data show an increase in the incidence rate in children and adolescents.

Occurrence/EpidemiologyThis section has been translated automatically.

1 to 4 % of all melanomas occur in children and adolescents < 20 years of age.

1.1% of patients in Australia with the first diagnosis of malignant melanoma were <20 years old.

Data from several studies show that the incidence rate increases after the age of 14.

A comparison showed an indication of greater tumour thickness in patients <10 years compared to patients >10 years.

ManifestationThis section has been translated automatically.

w:m=1.7:1.0

LocalizationThis section has been translated automatically.

trunk and extremities

Clinical featuresThis section has been translated automatically.

The clinical picture of juvenile malignant melanoma does not differ from that of adults (see below Melanoma, malignant). A tendency to clinically atypical malignant melanomas such as amelanotic or even bizarre nodular growths is observed. Lentigo-maligna melanoma is not observed in children.

Clinical features apply to BK mole syndrome and to malignant melanomas on giant melanocytic nevi (see nevus , melanocytic, nevus giganteus below); in giant melanocytic nevi, malignant degenerations have been found either within the nevus or also extracutaneously in about 5% of patients. > 50% of all observed malignant degenerations occur within the first 5 years of life.

General therapyThis section has been translated automatically.

Basically, the therapy of malignant melanoma in children and adolescents does not differ from that of adults.

The question of sentinel lymph node biopsy has not been conclusively answered. However, it is recommended as in adults from a TD≥1.0mm. This recommendation is based on the statement of an Australian working group.

Progression/forecastThis section has been translated automatically.

The median follow-up time in the above Australian study was 60 months (5-143 months) with an overall survival rate of 94.1% (48/51). The median tumor thickness in this collective was 1.7mm. The mean rate of positive SLNB was (astonishing) 25%.

The overall survival rate of the 14 patients with a positive SLNB at 60 months was 79% . In comparison, the overall survival rate at 60 months in a study of 356 adults with positive SLNB was 58%. From this, it can be concluded that the rate of positive SLNBs is higher in children and adolescents than in adults, but the survival rate is much more favorable (Howman-Giles R et al).

In a larger Dutch study, relative survival 1, 5, and 10 years after diagnosis was 98, 94, and 90%, respectively (Eggen CAM et al. 2018).

Ulceration, localization in the head and neck region, and Breslwo thickness >4.0mm predicted worse survival (El Sharouni MA et al. 2023).

Note(s)This section has been translated automatically.

One possible reason for the fact that melanomas in children have a higher average tumor thickness at the time of excision is the difficulty in making a diagnosis, another is the greater reluctance to make this rare suspected diagnosis in a child and to perform a diagnostic excision. Melanoma simulators are especially the pointed nevus and atypical melanocytic nevi.

LiteratureThis section has been translated automatically.

  1. Eggen CAM et al. (2018) Incidence and relative survival of melanoma in children and adolescents in the
    Netherlands, 1989-2013. J Eur Acad Dermatol Venereol 32:956-961.
  2. El Sharouni MA et al (2023) Melanomas in children and adolescents: clinicopathologic features and survival outcomes. J Am Acad Dermatol 88:609-616.Hamm H et al (2011) Skin Tumors in Childhood. Dtsch Arztebl 108: 347-353.
  3. Howman-Giles R et al (2010) Sentinel lymph node biopsy in pediatric and adolescent cutaneous melanoma patients. Ann Surg Oncol 17:138-143

Authors

Last updated on: 27.09.2023

Author: Prof. Dr. med. Peter Altmeyer