Malignant melanoma (MM) is a rare tumor in children; approximately 2% of all MM occur under the age of 20 years. The risk of melanoma before the age of 15 years is about 1 per million in that age range. The incidence is seven times greater in the second decade than in the first. Delay in diagnosis is frequent, as pathologists and clinicians may be reluctant to make a diagnosis of MM in children. Because of their rarity, large studies of MM in childhood are scarce. Clinical photographs of lesions are lacking in many studies. Histological diagnosis of MM in childhood has been regarded as so difficult that some studies have only included patients with metastatic disease. Early diagnosis of MM is as vital in children as it is in adults, and although early lesions may provide diagnostic difficulties, valuable information will be lost by ignoring tesions which have not metastasized. We have had the opportunity of assessing the clinical and histological features of 24 pigmented lesions in children, which we consider, must be regarded as MM.

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