The case illustrated here shows a nodular melanoma arising on the arm of a 8 year old boy (figures 1-5). This tumour shows: ulceration, lack of dermal maturation, dermal mitoses, pagetoid invasion of the epidermis and nuclear pleomorphism.
Given the reluctance of making this diagnosis in children, ancillary studies such as FISH and CGH can be helpful in increasing diagnostic confidence. FISH was performed on the case illustrated herein and showed numerous abnormalities, as would be expected for melanoma.
Immunohistochemical studies may be helpful to illustrate high proliferative rates (Ki-67), and pagetoid invasion (Melan-A).