Melanoma in Childhood and Adolescence: Clinical and Pathologic Features of Forty-Three Cases

摘要

Forty-three cases of melanoma occurring before age 20 years were reviewed from atwenty-one year period at a single center. Thirteen of the patients were preadolescent children, and 90% were Caucasian. Histologic review of 39 available primary tumors showed superficial spreading and nodular types only. Thickness ranged from 0.23 mm to 5.43 mm, with a mean of 1.58 mm. Ulceration was present in 8%, necrosis in 28%, evidence of regression in 21%, and antecdent nevus in 33% of cases. The overall 5 year survival is 79%, with a median follow-up of 42 months. There is no detectable survival difference between preadolescent children and adolescents. Several treatment failures occurred after improper bisopy and/or inaccurate original diagnosis of Spitz's nevus. Of 34 Stage I and II patients give definitive surgical treatment by the authors, the 5 year survival is 95%. Although histologic confusion with Spitz's nevi occasionally occurs, melanoma in this age group can be treated with good results. (js)