TREATMENT OF JUVENILE MELANOMAS AND MALIGNANT MELANOMAS IN CHILDREN

Abstract

The concept originally proposed by Pack¹ that malignant melanomas of childhood tend to follow a benign course has been cited repeatedly in medical writing. Theories of Pack^1b and of Spitz² that some as yet unknown hormonal influences inhibit malignant melanomas during childhood and stimulate them after puberty to become highly malignant also find frequent mention. Opposing this view have been reports of a small number of childhood lesions that appeared to be malignant melanomas histologically and clinically.³ Reflecting this background, the treatment of pigmented tumors in childhood is subject to contradictions and confusion. Conservative treatment of childhood malignant melanomas advised by Pack^1b is at variance with suggestions for radical excision and dissection of lymph nodes.⁴ Such formidable ideas as the prophylactic removal of all childhood pigmented nevi have been offered.⁵ Largely resolving these problems, Allen and Spitz⁶ recently presented a new and logical