By Sarah Elizabeth Richards<\/em><\/p>\n When Jesica Dunavent took her 4-month-old daughter, Addison, to her pediatrician for a checkup, she asked him about a little raised red spot on the infant\u2019s left arm below the elbow. The doctor took one look at the round bump, about half the size of a pencil eraser, and explained it was a hemangioma, a usually harmless birthmark often called a \u201cstrawberry mark\u201d that\u2019s common in newborns. \u201cEventually they go away,\u201d she recalls the doctor saying. \u201cThe clusters of blood get reabsorbed into the body.\u201d<\/p>\n Yet by the time Addison was in preschool, her bump was still there. In fact, it had grown to the size of a dime. Occasionally, the child would scratch at it or knock it against furniture and cause it to bleed. Or it would get dry and itch. When the top became scaly in appearance like a mushroom, her parents thought scar tissue was forming and agreed she should visit a dermatologist to have it removed.<\/p>\n That doctor didn\u2019t seem concerned, either. \u201cThis is nothing. We see this all the time,\u201d he had said after excising the growth in June of 2017. \u201cBut I\u2019m going to send it to a pathology lab [for examination under a microscope] just to make sure.\u201d<\/p>\n Later, when Jesica got a call from the dermatologist\u2019s office asking when she and Addison\u2019s father would be available to talk by phone, her heart sank, and she burst into tears. Jesica, who worked as a medical practice manager in Lambert, Mississippi, knew such a request wasn\u2019t usually good news.<\/p>\n An hour later, the parents learned their 4-year-old daughter had a type of skin cancer called a spitzoid melanoma<\/a> that is rare in children. She was referred immediately to St. Jude Children\u2019s Research Hospital, which was about an hour and a half away in Memphis, Tennessee. \u201cWhen I heard the news, I was blindsided,\u201d says Addison\u2019s dad, Caleb Dunavent.<\/p>\n \u201cIt was completely out of left field,\u201d adds Jesica. \u201cWhen I heard the word \u2018cancer,\u2019 I felt kicked in the gut.\u201d Consumed with dread, she spent the evening looking up information about melanoma survival rates. \u201cThat was probably the worst thing I could have done,\u201d she says. \u201cThere was hardly any information about pediatric versions of this cancer.\u201d Indeed, children account for only a tiny percentage of all new cases of melanoma in the United States, with about 400 cases a year in children under 20 years of age.<\/p>\n According to the National Cancer Institute, more than 90 percent of children and adolescents with melanoma were expected to be alive five years after their initial diagnosis. Yet just like in adult cases, the odds of survival were better if that cancer hadn\u2019t spread to other parts of the body. Still, her parents worried about whether their daughter\u2019s cancer had been growing this entire time.<\/p>\n The next task was to tell Addison. \u201cYou have to be straight with her. She\u2019s very strong and brave,\u201d says Jesica. \u201cWe explained that we were going to a hospital where they take care of kids with cancer and get it taken care of.\u201d<\/p>\n Pediatric melanoma<\/a> historically has received less research attention because it\u2019s so uncommon, yet doctors increasingly are learning more about the uniqueness of this childhood cancer. One reason is that they have new DNA sequencing tools and are able to study the genetic subtypes and better understand the particular risks. \u201cWe have come to recognize that not all pediatric melanoma cases are the same when you compare them to the adult population,\u201d says Alberto Pappo, MD, director of the Solid Tumor Division at St. Jude, who was Addison\u2019s doctor. In fact, the research hospital recently created a registry<\/a> that follows the progress of pediatric melanoma patients and includes molecular analyses of their cancer subtypes and treatment histories.<\/p>\n The kind that most closely resembles the melanoma that is seen in adults occurs mostly in adolescents ages 15 to 19, who account for 75 percent of all pediatric cases. There\u2019s another type that\u2019s aggressive but extremely rare that afflicts newborns and is characterized by a melanoma that arises in a large congenital nevus, or mole.<\/p>\n The tumors that usually develop in children who are younger than 10 are spitzoid melanomas, which appear as small lesions. The good news is that except for a handful of cases with a certain genetic marker, most spitzoid lesions aren\u2019t life-threatening. \u201cThe important thing to know is that these tumors behave very differently from the classic adult melanoma and that most patients have a very good prognosis,\u201d says Dr. Pappo.<\/p>\nNot the Same as Adult Melanoma<\/strong><\/h3>\n