Pediatric melanoma is rare and diagnostically challenging.
Characterize clinical and histopathological features of fatal pediatric melanomas.
Multi-center retrospective study of fatal melanoma cases in patients under 20 years diagnosed between 1994-2017.
Of 38 cases of fatal pediatric melanoma identified, 57% presented in Caucasian patients and 19% in Hispanic patients. Average age at diagnosis was 12.7 years (range 0.0-19.9) and average age at death was 15.6 years (range 1.1-26.2). Among cases with known identifiable subtypes, 50% were nodular (8/16), 31% superficial spreading (5/16), and 19% spitzoid melanoma (3/16). One-fourth (10/38) of melanomas arose in association with congenital melanocytic nevi.
Retrospective nature, cohort size, and potential referral bias.
Pediatric melanoma can be fatal in diverse clinical presentations, including a striking prevalence of Hispanic patients compared to adult disease, and with a range of clinical subtypes, though no fatal cases of spitzoid melanoma were diagnosed during childhood.

Copyright © 2020. Published by Elsevier Inc.

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