Predisposing Factors and Outcomes of Malignant Skin Tumors in Children

Abstract

Although benign and metastatic tumors occur in children, primary malignant skin tumors are uncommon in the pediatric population. In this study, the authors aimed to determine the incidence, risk factors, treatment, reconstruction details, and outcome of malignant skin tumors occurring in pediatric patients at the Hospital for Sick Children. The electronic database (CoPath) of the pathology department was searched for all cases of malignant skin tumors treated surgically between January of 2000 and September of 2008. Eighteen patients had been diagnosed and treated surgically for malignant skin tumors. The mean age was 10.4 years. Diagnosis of malignant melanoma was made in 14 patients, diagnosis of basal cell carcinoma was made in four patients, and diagnosis of squamous cell carcinoma was made in one patient. The most common sites of occurrence were lower limbs (33 percent) and face (28 percent). Gorlin syndrome was an underlying predisposing condition in three patients with basal cell carcinoma. All cases of basal cell carcinoma and squamous cell carcinoma underwent surgical resection and primary closure or skin graft. Of the patients with malignant melanoma, seven underwent surgical excision and primary closure and five had excision and skin graft. Eleven patients underwent sentinel node biopsy (Breslow thickness > or = 0.75 mm). Interferon was used as an adjuvant therapy in patients with positive regional lymph nodes. One patient with melanoma suffered a recurrence. Malignant skin tumors are rare in children. In accordance with previously published data, malignant melanoma was the most frequent tumor in our study. Epithelial tumors were less common and were all associated with an underlying predisposing condition.