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October 16, 1954


Author Affiliations

Rochester, Minn.

Fellow in Plastic Surgery (Dr. McWhorter), member of Section of Plastic Surgery and Laryngology (Dr. Figi), and member of Section of Surgical Pathology (Dr. Woolner), Mayo Clinic and Mayo Foundation. Dr. McWhorter is now practicing in Toledo, Ohio.

JAMA. 1954;156(7):695-698. doi:10.1001/jama.1954.02950070023006

The concept originally proposed by Pack1 that malignant melanomas of childhood tend to follow a benign course has been cited repeatedly in medical writing. Theories of Pack1b and of Spitz2 that some as yet unknown hormonal influences inhibit malignant melanomas during childhood and stimulate them after puberty to become highly malignant also find frequent mention. Opposing this view have been reports of a small number of childhood lesions that appeared to be malignant melanomas histologically and clinically.3 Reflecting this background, the treatment of pigmented tumors in childhood is subject to contradictions and confusion. Conservative treatment of childhood malignant melanomas advised by Pack1b is at variance with suggestions for radical excision and dissection of lymph nodes.4 Such formidable ideas as the prophylactic removal of all childhood pigmented nevi have been offered.5 Largely resolving these problems, Allen and Spitz6 recently presented a new and logical

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