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Robert J. Coffey, M.D.; William T. Berkeley, M.D.
JAMA. 1951;147(9):846-849. doi:10.1001/jama.1951.73670260001014.
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Malignant melanoma, originating from the common mole or nevus and characterized by a rapidly fatal course, is a relatively common neoplasm. According to Pack and his colleagues,1 no person's body is without one or two nevi, and in some instances their number may exceed 100.

Age is most important in consideration of the presence or absence of malignancy in these lesions. Nevi showing apparent malignant change before the onset of puberty are called prepubertal or juvenile melanomas. These lesions present a microscopic picture consistent with malignancy but are not associated with demonstrable metastasis or blood vessel invasion. It is not uncommon to encounter a histopathology report of a growing nevus in a child indicating that the tissue is microscopically malignant, but probably clinically benign. Experience has taught that a melanoma occurring prior to puberty rarely, if ever, pursues a malignant course.2 For this reason the diagnosis of malignant


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