Radicalization of surgical treatment in pediatric melanoma malignum

Abstract

I n t r o d u c t i o n . Melanoma is one of the most malignant cancers; however, melanoma in children is a very rare disease, accounting for only 1% of all new cases of cancer diagnosed annually. The objective of this paper is to present two cases of pediatric melanoma malignum with respect to model of surgical management related to stage of the disease with surgical approach based on current guidelines of American Joint Committee on Cancer (AJCC). C a s e r e p o r t s . In first case of 4-year old girl, the melanotic lesion was on the right arm and sentinel lymph node in in right axillary region. After sentinel lymph node biopsy (SLNB) of right axillary space and histologic diagnosis of confirmed malignancy, the patient was qualified for regional lymphadenectomy. The final staging was IIIC grade, and further therapy with interferon was continued. In the second case of 17-year old boy, with congenital naevus on the right earlobe, a SLNB of the right axillary lymph node was performed. Histologic examination of the lymph node did not reveal metastasis to the lymph node. The final was grade IIA and no further therapy was required. C o n c l u s i o n s . Both patients remain in complete clinical remission for 9 and 12 months after the diagnosis, confirmed by imaging and laboratory examinations. Both cases underline proper therapeutic approach based on radicalization of surgical treatment, sentinel lymph node biopsy followed by regional lymphadenectomy and interferon therapy in case of confirmed metastasis or no further therapy in case of negative histology of sentinel lymph node.