Screening Children

Question 1

Incidence of melanoma in children

Answer 1

0.62 (females) to 0.45 (males) / 100 000

Date 1970 through 2010

Question 2

Is incidence of melanoma in children increasing

Answer 2

No

Question 3

What % children have melanocytic nevus present at birth

Answer 3

1%

Question 4

Most common site congenital nevus

Answer 4

Trunk and thighs

Question 5

Congenital nevus categorized by size

Answer 5

Small < 2cm
Medium 2 - 20 cm
Giant > 20 cm

Question 6

When melanoma develops in a CN, it usually develops during the …..

Answer 6

Prepubertal period

Question 7

Half on melanomas in CN occur by age …

Answer 7

5

Question 8

The main focus on management of giant CN is …….

Answer 8

Multidisciplinary

MRI

Question 9

Risk factors for development of malignant melanoma

Answer 9

Giant congenital nevus
Dysplastic nevus syndrome
Light skin hair and eyes + blistering sunburn in childhood
Xeroderma pigmentosum
Genetically determined immunodeficiencies

Question 10

Cutoff for differences between children and adults

Answer 10

Puberty

Question 11

Children before puberty have …. (Re nevi)

Answer 11

Few or no nevi with exception of spitzoid lesions and congenital lesions

Question 12

What is NNE in children

Answer 12

Between 594 and 677 depending on study

In once study 22000 lesions excised to find 38 melanoma

Question 13

Most common pattern of nevi in children

Answer 13

Homogeneous or globular

Question 14

Significance of scalp nevus in children

Answer 14

Eclipse Nevis - brown periphery and white centre - the whitish component becomes elevated - predictive of moley child

Question 15

Where do you evaluate acral Nevis

Answer 15

In the periphery

Question 16

What is the “peas in a pod pattern”

Answer 16

Congenital acral nevus. In the centre there are commonly greyish globules.

Question 17

Pattern of mucosal nevi in children

Answer 17

Tend to be more globular

Question 18

Synonyms for Halo nevus

Answer 18

Sutton’s nevus

Nevi with concentric vitiligo

Question 19

Halo nevus is sometimes associated with …

Answer 19

Auto-immune disease

Question 20

With Halo nevus, if family hx of auto-immune disease one should screen for ….

Answer 20

Diabetes
thyroid disease
Celiac disease

Question 21

Reasons to worry about congenital nevi

Answer 21

Isolated intraparenchymal melanosis of the CNS
Melanoma risk
Cosmetic impact

Question 22

Congenital nevus syndrome

Answer 22

Intraparenchymal melanosis
Syringomyelia
Hydrocephalus
Other tumours
Other congenital abnormalities

Question 23

Principles of management giant congenital melanocytic nevi

Answer 23

1. MRI to rule out other abnormalities

2. Multi-disciplinary approach

Question 24

What % of children with CMN develop melanoma
Mean age of diagnosis
Median age
Major risk factor

Answer 24

0.7
15.5
7
CMN >= 40 cm

Question 25

Majority (63%) of CMN-associated melanomas exhibited which pattern?

Answer 25

Globular pattern in benign part

Blue white veil and irregular blotches in malignant part

Question 26

Congenital nevus - proliferative component.

1. Ddx
2. Most likely dx

Answer 26

Melanoma’

Benign

Question 27

Congenital nevus may …….. over time, especially in ….. location.

Answer 27

Fade

Acral

Question 28

Main argument against early surgical management if giant congenital nevus

Answer 28

Not eliminating melanoma risk completely

End up with similar cosmetic result

Question 29

What type of congenital nevi do we try to excise completely

Answer 29

Medium sized congenital nevi