Biomedical papers, 2016 (vol. 160), issue 3

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2016, 160(3):456-460 | 10.5507/bp.2016.018

Bone marrow metastasis of malignant melanoma in childhood arising within a congenital melanocytic nevus

Jana Volejnikovaa,b, Viera Bajciovac, Lucie Sulovskaa, Marie Geierovad, Eva Buriankovae, Marie Jarosovaf, Marian Hajduchb, Jaroslav Sterbac, Vladimir Mihala,b
a Department of Pediatrics, Faculty of Medicine and Dentistry, Palacky University Olomouc and University Hospital Olomouc, Czech Republic
b Institute of Molecular and Translational Medicine, Faculty of Medicine and Dentistry, Palacky University Olomouc, Czech Republic
c Department of Pediatric Oncology, Masaryk University, Brno and University Hospital Brno, Czech Republic
d Department of Clinical and Molecular Pathology, Faculty of Medicine and Dentistry, Palacky University Olomouc and University Hospital Olomouc, Czech Republic
e Department of Nuclear Medicine, Faculty of Medicine and Dentistry, Palacky University Olomouc and University Hospital Olomouc, Czech Republic
f Department of Hemato-Oncology, Faculty of Medicine and Dentistry, Palacky University Olomouc and University Hospital Olomouc, Czech Republic

Background: Malignant melanoma in childhood is infrequent and can arise within congenital melanocytic nevi. Spread of malignant melanoma to the bone marrow, especially in children, is extremely rare.

Methods and Results: Reported is a case of a 5-year-old boy with a congenital large melanocytic nevus of the head and neck who presented with a short history of low back and leg pain, fever and cervical lymphadenopathy. Despite regular follow-up by a dermatologist and plastic surgeon and repeatedly negative histology of previous partial excisions, diffuse bone marrow infiltration with malignant melanoma was diagnosed. The primary site was identified in the post-excision area. The disease progressed rapidly on ipilimumab immunotherapy and led to death at four months from the diagnosis.

Conclusion: Surveillance is indispensable in children with a predisposition to melanoma and nonspecific symptoms such as bone pain, gait impairment or cytopenia, should always be taken into account.

Keywords: bone marrow, childhood, congenital melanocytic nevus, malignant melanoma, metastasis

Received: October 29, 2015; Accepted: March 23, 2016; Prepublished online: April 1, 2016; Published: September 20, 2016


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