[3 children with a melanoma of the skin]

Melanoma rarely occurs in children not over 14 years of age. We report on the clinical and pathological features of three patients (two girls and one boy aged 6, 12 and 11 years respectively) from the St Laurentius hospital (Roermond, Netherlands) with melanoma of the skin, in whom the lesions histologically resembled the more frequently occurring spindle and epithelioid cell naevus (SE naevus). In all three cases, metastases were found in the regional lymph nodes. Further metastases were found in the last patient only, after follow-up periods of 29, 8 and 3 years respectively. The problems in distinguishing between melanoma and SE naevus are discussed, on the basis of a literature study and a retrospective analysis of 40 cases retrieved from PALGA (the nationwide computerized pathological archive in the Netherlands) up to and including 1990. As the diagnosis in such cases has important therapeutic consequences, we advise to submit the slides to experienced pathologists in the field, such as the Pathology Panel of the Dutch Melanoma Committee (Nederlandse Melanoom Werkgroep).