Melanoma

About melanoma in children

Melanoma is a type of cancer that starts in the cells that make melanin in skin pigment. These cells are called melanocytes. It may begin in a mole (skin melanoma), but can also begin in other types of pigmented tissue (such as the eyes or the intestines).

How common is melanoma?

Melanoma is the most common type of skin cancer in children. It is most common in children between age 10 to 19 years old, but can occur at other ages. Since 1975, melanoma rates have slowly increased. More than 400 children are diagnosed with melanoma each year. According to some reports the incidence of melanoma is increasing in children.

What are the risk factors associated with melanoma?

The risk of melanoma is increased by giant malanocytic nevi, which are large black spots, which may cover the trunk and thighs. It can also be increased by xeroderma pigmentosum, disorders of the immune system, or werner syndrome. Risk factors include:

  • Personal or family history of melanoma diagnosis
  • A history of very bad, blistering sunburns
  • Exposure to natural sunlight or artificial sunlight over a long period of time, such as from tanning beds
  • Having several large or many small moles
  • A family history of unusual moles. This is called nevus syndrome

What are the symptoms of melanoma?

A mole that: changes in size, shape or color; has irregular edges or irregular borders; is more than one color; is asymmetrical; a mole that itches; a mole that bleeds or oozes; a mole with an ulcer, where a hole forms in the skin and the underlying tissue shows through. Other risk factors include a change in skin color or pigmentation. Satellite moles may also by a symptom of melanoma. This occurs when there are new moles that begin to grow near an existing mole.

Where is melanoma most likely to be found?

Melanoma is most like to be found on an area of the body that has been exposed to the sun. Sun exposure can be linked to melanoma.

What is the treatment for patients with melanoma?

If the melanoma has spread only to lymph nodes, the treatment may include surgery to remove the cancerous tumor and lymph nodes, along with a medication treatment. If the melanoma has spread beyond the lymph nodes, treatment may include chemotherapy and other clinical trials. 

Evaluation and treatment

Melanoma can be difficult to diagnose in children as they often do not have the classic ABCDE criteria used in adults. Each child suspected of having melanoma is evaluated by our multidisciplinary team consisting of pediatric dermatologist, oncologist and pathologist. If detected at early stages, melanoma can be treated with surgery alone. For advanced stage melanoma, we offer a combination of surgery, radiation and medical therapies.

Research

At Texas Children’s Cancer and Hematology Centers, we are further interested in understanding pediatric melanoma  with the goal of offering more successful therapies for pediatric patients. We have established the North American Pediatric Melanoma registry to collect information on children with melanoma. Email us at raretumors@txch.org for information on how to enroll in the registry.

Second opinions

We welcome oncologists to contact us for second opinion consultations about the care and management of individual patients.