Malignant Melanoma May Be Missed in Children

Delayed diagnosis and other problems can lead to more advanced stage at diagnosis

WEDNESDAY, Nov. 9 (HealthDay News) -- A lack of awareness can lead to a delayed diagnosis in children with melanoma, which may result in an increased incidence of thick and intermediate lesions, according to a study in the November issue of the Journal of the American Academy of Dermatology.

Fatemeh Jafarian, M.D., of Sainte-Justine Hospital in Montreal, and colleagues reviewed 13 cases of malignant melanoma in children under 17 evaluated at Sainte-Justine Hospital between 1980 and 2002.

Some 53% of the patients were pre-pubescent. There were four boys and nine girls, and none had a predisposing condition. One patient had undergone chemotherapy for an undifferentiated pleuropulmonary malignant tumor; another had Down syndrome.

The researchers found that the most common reason for initial consultation was a recent increase in the lesion's size. Three patients had pyogenic granuloma-like lesions. Some 85% of the observed melanomas were granular. Five-year survival rate was 58.8%.

"Because it appears that the majority of melanomas in childhood and adolescence occur de novo, clinicians should consider this condition in the differential diagnosis of any suspect lesion in children and adolescents even without an identified predisposing factor."

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