TY - JOUR
T1 - Pediatric melanoma
T2 - a single-institution experience of 150 patients
AU - Aldrink, Jennifer H.
AU - Selim, M. Angelica
AU - Diesen, Diana L.
AU - Johnson, Jeffrey
AU - Pruitt, Scott K.
AU - Tyler, Douglas S.
AU - Seigler, Hilliard F.
PY - 2009/8
Y1 - 2009/8
N2 - Purpose: Differentiating pigmented skin lesions from malignant melanoma in the pediatric population has been a challenge. Despite guidelines describing clinical features and histopathologic criteria to distinguish these lesions, misdiagnoses still occur. We report our experience over 30 years in a pediatric population with malignant melanoma. Methods: We performed a retrospective review of 150 pediatric patients treated for malignant melanoma between 1973 and 2007 at our institution. Outcomes measured included age, Breslow thickness, Clark level of invasion, tumor location, local and distant failure rates, and overall survival. Results: One hundred fifty pediatric patients were evaluated. The mean age was 15.1 years. The mean Breslow thickness was 2.05 mm and corresponding Clark level of invasion was 3.47. There were 43 known recurrences (29%); 29 distant, 14 nodal, and 7 local. Overall survival was 84% with a mean follow-up of 8.5 years. Sixteen patients (10.7%) were incorrectly diagnosed on initial pathologic examination. Overall survival in the misdiagnosed group was 66%. Conclusion: Pigmented skin lesions in the pediatric population represent a diagnostic challenge to pathologists and clinicians. Improvements in diagnostic techniques with rigorous characterization, as well as increased physician awareness, should lead to a reduction in errors of diagnosis.
AB - Purpose: Differentiating pigmented skin lesions from malignant melanoma in the pediatric population has been a challenge. Despite guidelines describing clinical features and histopathologic criteria to distinguish these lesions, misdiagnoses still occur. We report our experience over 30 years in a pediatric population with malignant melanoma. Methods: We performed a retrospective review of 150 pediatric patients treated for malignant melanoma between 1973 and 2007 at our institution. Outcomes measured included age, Breslow thickness, Clark level of invasion, tumor location, local and distant failure rates, and overall survival. Results: One hundred fifty pediatric patients were evaluated. The mean age was 15.1 years. The mean Breslow thickness was 2.05 mm and corresponding Clark level of invasion was 3.47. There were 43 known recurrences (29%); 29 distant, 14 nodal, and 7 local. Overall survival was 84% with a mean follow-up of 8.5 years. Sixteen patients (10.7%) were incorrectly diagnosed on initial pathologic examination. Overall survival in the misdiagnosed group was 66%. Conclusion: Pigmented skin lesions in the pediatric population represent a diagnostic challenge to pathologists and clinicians. Improvements in diagnostic techniques with rigorous characterization, as well as increased physician awareness, should lead to a reduction in errors of diagnosis.
KW - Pediatric melanoma
KW - Spitz nevus
UR - http://www.scopus.com/inward/record.url?scp=67650932360&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=67650932360&partnerID=8YFLogxK
U2 - 10.1016/j.jpedsurg.2008.12.003
DO - 10.1016/j.jpedsurg.2008.12.003
M3 - Article
C2 - 19635298
AN - SCOPUS:67650932360
SN - 0022-3468
VL - 44
SP - 1514
EP - 1521
JO - Journal of Pediatric Surgery
JF - Journal of Pediatric Surgery
IS - 8
ER -