Subnugal melanoma? Toddler, should I push for a biopsy.

Hi everyone,

I’m feeling really anxious and would love some advice or reassurance. My little one (2 years old) has had a vertical black line on their thumb for about 5 months. It’s around 2mm, no history of trauma, and in the last month, it has definitely grown and darkened—though not dramatically, it’s still noticeable.

We were referred to the dermatology unit at the hospital, and today we had our appointment. One specialist examined it and told their colleague they would recommend a biopsy because the line seems to extend slightly ito the nailbed. However, their colleague said that they don’t usually do biopsies in children that young and prefer to monitor instead as it is usually benign

They then called in another doctor for a third opinion. She reassured us that subungual melanoma is extremely rare in children—so rare that she doesn’t think there’s ever been a reported case in a child this young. She also said the borders were straight and regular, so she wasn’t concerned and decided against a biopsy. Instead, they took photos and plan to review it again in a few months.

What’s been playing on my mind is something I overheard. One doctor asked, “So do we not usually check again on children this young?” and the senior doctor responded, “Not usually.”

Now I’m worried—why did she say that? Does this mean they’re considering the possibility of something serious but don’t want to alarm me? Should I push for a biopsy now instead of waiting?

I just can’t shake the anxiety, and I don’t want to regret not acting sooner if it turns out to be something serious. Has anyone been through something similar? Would really appreciate any advice or thoughts.

Thank you

  • Welcome to the forum, EHGR,
    I can hear how anxious you must be feeling right now, and it’s completely understandable given the situation. It’s always so worrying when it comes to our little ones, and it sounds like you’re doing everything you can to make sure they get the right care.
    It’s good to hear that you've already seen specialists and that they’ve decided to monitor the situation for now. It’s reassuring to know that subungual melanoma is extremely rare in young children, and I’m sure the doctors are considering all factors when making their decisions. The fact that they’re taking photos and planning to reassess it in a few months shows they’re keeping a close eye on it, which must offer some reassurance.
    That said, it’s natural to feel uncertain, especially when you overhear things that raise more questions. If you’re still feeling unsure or anxious, it might help to ask the medical team for a bit more clarity on why they opted for monitoring rather than a biopsy. You can also always ask about your options for a second opinion, or discuss any concerns further to make sure you're comfortable with the plan going forward.
    Remember, you're not alone in this. Many parents have shared similar experiences and concerns, and I hope some others will be here soon to offer their thoughts and advice.
    Wishing you and your little one all the best,
    Renata, Cancer Chat Moderator