In 1979, Stomberg³² reported on six children who had been seen during an 18-year period at Case Western Reserve University Hospitals. Two of the melanomas were said to have been present since birth, one in association with a giant nevus (the melanoma extended from the temporal region through the dura) and the other in what otherwise seemed to be normal skin of the left mastoid process of a 4-month-old infant (it metastasized to retroauricular lymph nodes). Of the four melanomas that developed after birth and apparently de novo, one occurred on the pinna of the left ear of a 9-year-old girl and subsequently metastasized to cervical lymph nodes; a second was on the back of a 12-year-old boy and it, too, gave rise to metastasis; the third was a 2 mm melanotic nodule that occurred on the upper left eyelid of a 14-year-old black girl, and the last was on the lateral right upper arm of a 14-year-old boy. The14-year-olds had no evidence of metastatic disease after follow-up of 13 years and two years, respectively. Stomberg never defined precisely what he meant by "prepubertal," but one may infer that he meant 14 years of age and younger. Stromberg stated that "the cases presented have satisfied the strict pathological criteria for malignant melanoma," but he showed no photomicrographs to reinforce that assertion. In his judgment, "prognosis [for persons with prepubertal malignant melanoma] does not differ markedly from similar lesions in adults."

Under the title, "Malignant melanoma in children and adolescents," Pratt and associates,³³ in 1981, detailed the clinical features of melanoma in 31 patients who were less than 21 years of age. No photomicrographs were shown, but Pratt et al. commented tersely on the histopathological findings in those neoplasms thus:

Those changes, presented somewhat vaguely, are not distinguishing from findings in some examples of Spitz's nevus (benign juvenile melanoma, spindle and epithelioid cell nevus). With respect to survival, Pratt and co-workers made these observations: