Atypical spitzoid melanocytic tumors with positive sentinel lymph nodes in children and teenagers, and comparison with histologically unambiguous and lethal melanomas Journal Article
| Authors: | Busam, K. J.; Murali, R.; Pulitzer, M.; McCarthy, S. W.; Thompson, J. F.; Shaw, H. M.; Brady, M. S.; Coit, D. G.; Dusza, S.; Wilmott, J.; Kayton, M.; Laquaglia, M.; Scolyer, R. A. |
| Article Title: | Atypical spitzoid melanocytic tumors with positive sentinel lymph nodes in children and teenagers, and comparison with histologically unambiguous and lethal melanomas |
| Abstract: | Children and teenagers with a positive sentinel lymph node (SLN) after a prior diagnosis of an atypical spitzoid melanocytic tumor (ASMT) are usually cared for clinically in the same way as patients with melanoma. Little is known about long-term follow-up of these individuals to determine whether this practice is appropriate. To learn more about the biology of these tumors we retrospectively reviewed the clinical and pathologic findings of children and teenagers (<18-y of age at the time of diagnosis) with an ASMT, positive SLN and follow-up of at least 3 years. Their findings were compared with histologically unambiguous melanomas of children or teenagers, who had a positive SLN or died of metastatic melanoma. Eleven individuals, 6 girls and 5 boys, with primary ASMT and positive SLN were identified. The primary tumors ranged in thickness from 2.1 to 12-mm (median, 4.6-mm; mean, 5-mm). The tumor mitotic rate ranged from 1 to 10 mitoses/mm (median, 3/mm, median, 3/mm). The positive SLNs included 6 nodes with intranodal melanocytic aggregates measuring <1-mm in greatest dimension, and 5 nodes, in which the size of the melanocyte deposits was ?-1-mm. All the patients with ASMT and positive SLN remained free of disease with a median follow-up of 47 months (mean, 61-mo, range: 36 to 132-mo). In contrast, 2 of 5 patients <18 years of age with a histologically unambiguous melanoma and a positive SLN died of metastatic melanoma. The overall disease-specific mortality rate for all patients <18 years of age diagnosed with melanoma was 12%. Our findings confirm that children and teenagers with ASMTs and positive SLNs have a less aggressive clinical course than those with histologically unambiguous melanoma. Copyright © 2009 by Lippincott Williams & Wilkins. |
| Keywords: | adolescent; child; clinical article; controlled study; human tissue; preschool child; school child; disease-free survival; cancer surgery; primary tumor; disease course; histopathology; comparative study; follow up; cancer diagnosis; diagnostic accuracy; sentinel lymph node; sentinel lymph node biopsy; cell structure; melanoma; skin neoplasms; melanocyte; tumor volume; retrospective study; cancer mortality; childhood cancer; professional practice; cancer size; long term care; juvenile melanoma; spitz nevus; spitzoid melanocytic tumor; atypical spitzoid melanocytic tumor; cell aggregation; cell size; mitosis rate; nevus, epithelioid and spindle cell |
| Journal Title: | American Journal of Surgical Pathology |
| Volume: | 33 |
| Issue: | 9 |
| ISSN: | 0147-5185 |
| Publisher: | Lippincott Williams & Wilkins |
| Date Published: | 2009-09-01 |
| Start Page: | 1386 |
| End Page: | 1395 |
| Language: | English |
| DOI: | 10.1097/PAS.0b013e3181ac1927 |
| PUBMED: | 19609204 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | --- - "Cited By (since 1996): 8" - "Export Date: 30 November 2010" - "CODEN: AJSPD" - "Source: Scopus" |
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