Many pediatric melanoma lesions present at a more advanced stage than those
in the adult population. Clinical and histological melanoma mimics, includ
ing a subset of Spitz nevi, are difficult to discriminate from melanoma. Wh
en dealing with a childhood melanoma, the clinician is likely to be faced w
ith a thick lesion, and one in which the actual diagnosis may even be in do
ubt. There is a paucity of data to guide the physician in his management of
melanoma in this age group, particularly with respect to node status and a
djuvant therapy. The authors present two cases of pediatric melanoma in whi
ch the novel use of sentinel node biopsy helped confirm the diagnosis of me
lanoma, determined the need for full lymph node dissection, and guided the
use of adjuvant interferon therapy.