Conclusion
Pediatric melanoma appears to present at more advanced stages in
comparison to adult melanoma, though pediatric patients have a
relatively outstanding outcome in our cohort. Incorporating nivolumab
into the initial treatment of melanoma in the pediatric population may
be associated with decreased progression and recurrence in children
diagnosed at stage III with at least one positive SLN. While more
extensive research into its toxicity and its application in pediatric
melanoma is needed, nivolumab appears safe and well-tolerated in our
small pediatric cohort. Our data support that histological ulceration
does not seem to be an indicator of poor prognosis for melanoma in the
pediatric population and that melanoma in children is more likely to
arise de novo rather than a pre-existing melanocytic nevus. These
differences between melanoma in children and adults may explain why
children are being diagnosed at more advanced stages. Therefore, more
research outside of the established clinical and histopathologic
features used for the adult population is needed.
TABLE 1 . Patient demographic data and melanoma types.