Bone marrow and cervical lymph nodes metastases as prodromal manifestations of malignant melanoma in a child

Malignant melanoma in children is rare. It can arise from congenital melanocytic nevi. In pediatric patients, diagnosis of melanoma is difficult and challenging because the physicians have a low index of suspicion. Marrow metastasis in malignant melanoma especially in children is extremely uncommon. Here, the authors reported a 5 year old girl who was presented with a 4 month history of pelvic and right lower limb pain and limping to the pediatric outpatient clinic in August 2016  at Shahid sadoughi Hospital,Yazd,Iran. She was febrile and had right cervical lymphadenopathy and scalp congenital nevus. The investigations confirmed the diagnosis of malignant melanoma with marrow and cervical lymph node metastases. The patient underwent multidisciplinary management and she was followed up closely. Metastatic malignant melanoma is a rare and dangerous disease with poor prognosis in children. It should be considered in differential diagnosis of children with congenital melanocytic nevi.