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.