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Case Rep Oncol Med. 2015;2015:298273. doi: 10.1155/2015/298273. Epub 2015 Feb 11.

Nonpigmented metastatic melanoma in a two-year-old girl: a serious diagnostic dilemma.

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Izmir Tepecik Education and Research Hospital, Pathology Laboratory, Turkey.
Izmir Dr. Behcet Uz Children's Hospital, Pathology Laboratory and Dermatology Clinics, Turkey.
Pediatric Oncology Clinics, Izmir Dokuz Eylul University, Turkey.


Although rare, malignant melanoma may occur in children. Childhood melanomas account for only 0.3-3% of all melanomas. In particular the presence of congenital melanocytic nevi is associated with an increased risk of development of melanoma. We herein report a case of malignant melanoma that developed on a giant congenital melanocytic nevus and made a metastasis to the subcutaneous tissue of neck in a two-year-old girl. The patient was hospitalized for differential diagnosis and treatment of cervical mass with a suspicion of hematological malignancy, because the malignant transformation of congenital nevus was not noticed before. In this case, we found out a nonpigmented malignant tumor of pleomorphic cells after the microscopic examination of subcutaneous lesion. Nonpigmented metastatic melanoma was diagnosed by several immunohistochemical and flow cytometric studies. She was offered palliative chemotherapy; however, her parents did not accept treatment. The patient died within 9 months of diagnosis. We emphasized here that the possibility of malignant melanoma in the differential diagnosis of childhood tumors should be kept in mind.

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