Malignant melanoma during pregnancy has an estimated incidence of between 0.14 and 2.8 cases per 1000 births and represents 8% of malignancies diagnosed during pregnancy. However, 35-40% of women with melanoma are of childbearing age. From the registry of the German Dermatological Society, it was found that 1% of female melanoma patients were pregnant.The signs and symptoms of melanoma are similar to the non-pregnant population and the anatomic location of the primary tumor does not differ between pregnant and non-pregnant women. Excisional biopsy is the recommended procedure for any suspicious lesions. Clinical staging traditionally has included assessment of the local tumor site and adjacent skin, regional lymph node areas and distant organs that are frequently the site of metastatic disease. The decision to perform radiological investigations in the pregnant patient should be based on the presence of symptoms, the stage of pregnancy, the specific test needed and the estimated dose of ionizing radiation and risks associated with that dose. Intensive radiological investigation is not required for patients with early disease.Surgical removal of the melanoma with adequate margins remains the standard primary therapy for early melanoma. Elective lymph node dissection is not recommended. Sentinel node biopsy is a promising method to detect occult metastases in the regional lymph nodes. For most patients, this procedure can be done with a local anaesthetic with little risk to the fetus. The use of adjuvant interferon alpha in patients with melanoma is controversial and remains experimental. In the absence of evidence, it should not be used during pregnancy.
