Amelanotic melanoma in Child
Unlike in adults, amelanotic melanoma accounts for a significant proportion of pediatric melanoma, particularly in younger children. About 75% of melanoma cases are amelanotic among children 10 years and younger, and about 25% among those 11-19 years of age.
Risk factors for melanoma in children include genetic predisposition, such as family history and lighter skin phenotype, as well as history of sunburns, sun exposure, tanning, and immunosuppression. Hereditary conditions such as inherited DNA repair defects, hereditary retinoblastoma, and Werner syndrome also increase the risk of developing melanoma in childhood.
Because of its lack of pigment and potential resemblance to several benign lesions, amelanotic melanoma is often associated with a delay in proper diagnosis and treatment. Amelanotic melanomas that mimic benign lesions are associated with a higher Breslow depth, higher histopathologic stage, and a more common history of clinical ulceration and bleeding compared to clinically more obvious melanomas. Among children 10 years and younger, where melanoma most commonly presents as amelanotic, the most common subtypes include Spitz (26%) and nodular melanoma (16%).
C43.9 – Malignant melanoma of skin, unspecified
276751004 – Amelanotic malignant melanoma of skin
Differential Diagnosis & Pitfalls
- Spitz nevus
- Compound nevus
- Intradermal nevus
- Acquired nevus
- Congenital nevus
- Dysplastic nevus
- Nevus sebaceus
- Lobular capillary hemangioma (pyogenic granuloma)
- Infantile hemangioma
- Cherry hemangioma
- Juvenile xanthogranuloma
- Verruca vulgaris
- Epidermoid cyst
- Basosquamous carcinoma