Melanoma In Children Research Articles

Melanoma in children and adolescents.

Melanoma in children and adolescents.

Malignant melanoma in childhood.

Malignant melanoma in childhood.

Wherein lies the truth? Assessment of agreement between parent proxy and child respondents.

The epidemiological study of diseases of childhood presents a special situation in that the principal respondent is almost always a person other than the index. Use of proxy respondents in paediatric epidemiology has been little studied compared with the use of surrogate respondents for adults. Agreement between responses from children and their parents to identical questions about the children was assessed in a case-control study of childhood melanoma in Queensland, Australia. Weighted kappa and log-linear modelling techniques were used to measure agreement for ordinal data. Highest agreement was found for reports of unchanging physical characteristics such as eye colour (kappa = 0.88), hair colour (kappa = 0.76), and for history of residing on a farm (kappa = 0.84). Moderate agreement was seen for density of facial freckling (kappa = 0.62), propensity to sunburn (kappa = 0.46) and tanning ability (kappa = 0.47). Variables with low levels of agreement between parent proxy and child respondents included density of freckling on the shoulders (kappa = 0.28) and degree of moliness of the skin at age 5 years (kappa = 0.24). Agreement did not vary according to age or sex of the children. Log-linear modelling was performed to determine the type and magnitude of components of agreement. Agreement between responses from children and parent proxies depends largely upon the type of information sought, rather than characteristics of the respondents.

Brain metastases in children with melanoma.

Brain metastases complicate the course of malignant melanoma in at least 20% of adult cases. These events are commonly preceded by metastases to other sites. Due to the rarity of malignant melanoma in children, little is known about the incidence, clinical features, and outcome of children with melanoma who develop brain metastases. The authors reviewed the records of 44 children with malignant melanoma treated at St. Jude Children's Research Hospital over a 33-year period. Eight (18%) developed brain metastases during the course of their disease. The authors reviewed the clinical and radiologic features of six of these cases, for whom complete clinical information and imaging studies were available. The median age at diagnosis of malignant melanoma was 15 years (range, 11-21 years). Brain metastases developed a median of 20 months (range, 0-50 months) after diagnosis and were preceded by metastases to other organs in 5 patients. In most cases, lesions were supratentorial and multiple. Most showed radiologic signs of intralesional hemorrhage. All patients received whole brain radiotherapy, and one had surgical resection. Three patients received chemotherapy. Five patients died a median of 5 months (range, 2-10 months) after diagnosis of brain involvement. One patient, who had a single brain metastasis at diagnosis, is alive more than 34 months later. Brain metastases develop in a significant proportion of children with malignant melanoma and are associated with a poor outcome. The incidence, features, and outcome in children do not appear to differ from those in adults.

Cutaneous malignant melanoma in children and adolescents in Sweden during two decades, 1973???1993

Cutaneous malignant melanoma in children and adolescents in Sweden during two decades, 1973???1993

Cutaneous melanoma in childhood and adolescence

Cutaneous melanoma in childhood and adolescence

Melanoma in childhood

Melanoma in childhood

Differences in Malignant Melanoma Between Children and Adolescents

To investigate whether there was an increase of malignant melanoma in children. Malignant melanomas are rare in people younger than 20 years. Although melanoma represents one of the most rapidly increasing neoplasm in adults, it is rarely studied in children. Retrospective study from 1958 through 1992. The compulsory Swedish Cancer Registry in Stockholm, Sweden. We present 287 cases of malignant melanoma in patients younger than 20 years during 35 years in Sweden. None. Data from cancer reports and death certificates in Sweden. The study shows a strong increase in malignant melanomas in puberty after a presumably constant prevalence before the age of 14 years. The melanomas are more common in females (162) than males (125). The distribution was the same as in adults. Of 287 cases, 44 patients died as a result of their tumors (15.3%), with a median survival time of 3 years after diagnosis. The incidence of malignant melanoma during adolescence has doubled in 10 years. This is not the case for the incidence of melanomas in children younger than 14 years, which seems to be unchanged. It is necessary to be aware of the risk of malignant melanomas in children after puberty.

Malignant melanoma in children. A review

Malignant melanoma in children. A review

Vulvar Melanoma in Childhood

Malignant melanoma is rarely diagnosed during childhood. Approximately 2% of malignant melanomas occur in patients younger than 20 years, with 0.3% to 0.5% of cases occurring in prepubescent children. In adult females malignant melanoma of the vulva and vagina is 100-fold less common than malignant melanoma of nongenital skin. Malignant melanoma of the vulva occurring in a child has been reported once before. We report 2 cases of childhood vulvar malignant melanoma presenting in preteenage girls. In both cases, the lesions were asymptomatic enlarging hyperpigmented macules on the labium minus. In addition to features diagnostic of malignant melanoma, histological evidence of lichen sclerosus et atrophicus was identified in both lesions. Local excision with conservative margins was the treatment modality of choice in both cases, with good preservation of anatomic structure and function. This report is of 2 cases of vulvar melanoma in childhood, a rare, yet potentially devastating, presentation of melanoma. Biopsies on suspicious pigmented lesions on the vulva of prepubescent children should be done to rule out malignant change.

Melanoma in children and adolescents.

Melanoma is a life-threatening and rare malignancy in childhood and adolescence. Because it is so uncommon, melanoma may not be recognized readily or considered seriously in a differential diagnosis, resulting in delays in definitive treatment. We review melanoma occurring in 13 patients under 20 years of age who presented to a single tertiary care children's hospital. Five patients had nonmetastatic primary cutaneous melanoma, with Breslow thickness measurement ranging from 0.84 to 7.8 mm. Three patients had metastatic primary cutaneous melanoma, three had metastatic melanoma arising ina congenital giant nevus, and two had primary leptomeningeal melanoma. All of the patients were given definitive surgical treatment; some received adjunctive radiation therapy and chemotherapy. Overall 5-year survival rate was 40.0% for all cutaneous melanomas, which included 100% for clinical stage I disease, and 0% for clinical stage II and III disease. Both patients with primary leptomeningeal melanoma died an average of 6 months following diagnosis. Nonmetastatic primary cutaneous melanoma is a survivable disease if detected early and treated by surgical excision; metastatic and leptomeningeal disease were uniformly fatal. Types of melanoma, risk factors for melanoma, and the role of the dermatologist in primary prevention and detection are discussed.

Cutaneous melanoma in childhood: incidence and prognosis.

The incidence and prognosis of cutaneous melanoma in children under 13 years of age has always been difficult to assess. The main reasons for this difficulty include the rarity of melanoma in children, referral biases from investigating institutions, changing conceptions in the histological diagnosis of true melanoma, and the lack of large enough study groups with sufficient follow-up to estimate 10-year survival rates. The present study documents 32 cases of childhood cutaneous melanoma drawn from the records of two large referral centres in New South Wales, Australia: the Sydney Melanoma Unit and the Newcastle Melanoma Unit in order to demonstrate some of the difficulties in the assessment of incidence and prognosis in children.

Childhood melanoma: a clinicopathological study of 22 cases

Childhood melanoma is a rare disease with an estimated incidence of one per million per year. Careful study of childhood melanoma patients is critical due to the limited data currently available pertaining to this disease. Twenty-two children 15 years of age or under with malignant melanoma were treated at the Pigmented Lesion Clinic of Massachusetts General Hospital over a 33-year period. The medical records of all patients were reviewed, as well as the histologic characteristics of the lesions. Patients who were initially diagnosed with malignant melanoma but on review found to have Spitz naevi were not included in our study. Ten patients were boys and 12 were girls. The median ages of the boys and girls in our study were 12.9 and 13.6 years, respectively. Among the classified primary melanomas, 10 were superficial spreading, three were borderline/minimal deviation, two were nodular and one was melanoma in situ. Four of 22 patients had a documented family history of melanoma, and two additional patients had a family history of dysplastic naevi. A majority of lesions (14/22) arose in association with a precursor lesion. Two children died of disease at 1 and at 7 years following initial diagnosis. Eight patients had documented metastases. Since the majority of melanomas arose in association with a precursor lesion, follow-up of children with congenital and/ or dysplastic naevi is recommended. An interesting finding was the sometimes paradoxical behaviour of relatively thin lesions with metastases. Thus, a high index of suspicion is needed by the clinician confronted with melanocytic lesions of childhood. We found children from age 12 to 15 to be more at risk for the development of melanoma than younger children. Melanoma presenting before the age of 10 is very unusual.

Risk factors for childhood melanoma in Queensland, Australia

The causes of cutaneous melanoma among children under 15 years are largely unknown. We report the findings of an epidemiological study of childhood melanoma in Queensland, Australia, which has the highest incidence rates in the world. All 61 cases of melanoma in children less than 15 years notified to the Queensland Cancer Registry 1987–1994 were eligible to participate in a population-based, case-control study. Data were collected through structured, face-to-face interviews with parents and skin examinations of the 52 participating cases and 156 age-and sex-matched controls. The strongest determinants of melanoma risk found among Queensland children were constitutional factors, including the presence of more than 10 naevi greater than 5 mm in diameter (RR 9.9, 95% CI 2.5–38.9), heavy facial freckling (RR 6.4, 95% CI 1.9–21.6), an inability to tan on exposure to the sun (RR 8.8, 95% CI 2.1–36.2) and a family history of melanoma (RR 4.2, 95% CI 1.9–9.3). These factors remained significantly associated with melanoma after adjusting for other risk factors. No measures of acute or chronic exposure to solar UV radiation were associated with childhood melanoma in our study. Established risk factors, including giant congenital naevi and xeroderma pigmentosum, were not present among any of the children in the study. Melanoma in childhood appears to have similar epidemiologic characteristics to the adult form of the disease, being associated with a cluster of phenotypic attributes indicating cutaneous sensitivity to the effects of sun exposure. Our findings support the contention that childhood melanoma occurs in susceptible individuals with a low threshold for pigment cell tumorigenesis. From a public-health perspective, children at elevated risk for melanoma can be identified on the basis of phenotype and family history. © 1997 Wiley-Liss, Inc.

Risk factors for childhood melanoma in Queensland, Australia.

The causes of cutaneous melanoma among children under 15 years are largely unknown. We report the findings of an epidemiological study of childhood melanoma in Queensland, Australia, which has the highest incidence rates in the world. All 61 cases of melanoma in children less than 15 years notified to the Queensland Cancer Registry 1987-1994 were eligible to participate in a population-based, case-control study. Data were collected through structured, face-to-face interviews with parents and skin examinations of the 52 participating cases and 156 age- and sex-matched controls. The strongest determinants of melanoma risk found among Queensland children were constitutional factors, including the presence of more than 10 naevi greater than 5 mm in diameter (RR 9.9, 95% CI 2.5-38.9), heavy facial freckling (RR 6.4, 95% CI 1.9-21.6), an inability to tan on exposure to the sun (RR 8.8, 95% CI 2.1-36.2) and a family history of melanoma (RR 4.2, 95% CI 1.9-9.3). These factors remained significantly associated with melanoma after adjusting for other risk factors. No measures of acute or chronic exposure to solar UV radiation were associated with childhood melanoma in our study. Established risk factors, including giant congenital naevi and xeroderma pigmentosum, were not present among any of the children in the study. Melanoma in childhood appears to have similar epidemiologic characteristics to the adult form of the disease, being associated with a cluster of phenotypic attributes indicating cutaneous sensitivity to the effects of sun exposure. Our findings support the contention that childhood melanoma occurs in susceptible individuals with a low threshold for pigment cell tumorigenesis. From a public-health perspective, children at elevated risk for melanoma can be identified on the basis of phenotype and family history.

１４歳女子の足縁に生じた黒色結節

Malignant melanoma in childhood is very rare and is often misdiagnosed as Spitz nevus because of their histological similarities. Our patient was 14-year-old girl who had enlarging, raised, pigmented nodule on her left foot. Histopathologically, it showed some features of Spitz nevus. The tumor cells were composed of atypical, pleomorphic epithelioid cells. Mitotic figures were very sparse and small nevoid cells were seen in the deeper potion. But the cyto-fluorometric analysis of nuclear DNA content showed pattern IV, aneuploid pattern. The results of fluorescence microscopy of unstained sections and immunostaining with HMB-45 also suggested the malignant change.

PEDIATRIC DERMATOLOGY

The latest studies regarding the controversial and concerning subjects of pigmented nevi and melanoma in children are reviewed. Additional topics covered include dermatologic conditions that feature genetic mosaicism, theories of pathogenesis of Langerhans cell histiocytosis, new clinical information regarding juvenile xanthogranulomas, and the unique features of pyoderma gangrenosum in infants and children.

Cutaneous Malignant Melanoma in Children and Adolescents in Scotland, 1979-1991

All cases of cutaneous malignant melanoma in Scotland have been registered by the Scottish Melanoma Group since 1979, and there are currently more than 4700 cases on the registry. Of these, only 50 cases are in patients 18 years of age and younger (1.04 percent of all melanomas); 15 of these were prepubertal, i.e., 14 years or younger (0.3 percent of all melanomas). The nine cases of documented metastases occurred in children with tumor thickness of 1.50 mm or more, with only one of these metastases occurring in a prepubertal child. Eight of these patients with metastatic disease died, with a maximum survival of 4 years. A reliable clinical history was obtained from the families of 23 patients. Eight of them had a history of preexisting congenital nevocellular nevus. In this series, no case arose in a large congenital nevocellular nevus. Histological review showed that the majority of cases (58 percent) exhibited typical cytological and architectural features of malignant melanoma. In the remaining cases, the lesions were difficult to fit into any of the classic patterns of malignant melanoma or of the known benign nevocellular lesions.

Melanoma in Children

Malignant melanoma is rare in children -- the risk before age 15 years is one per million. Because malignant melanoma is so rare, clinicians and

Malignant melanoma in childhood

Malignant melanoma (MM) is rare in childhood. We report 24 cases of MM in children 16 years old or less, whose histopathological specimens were referred to our department from 1981 to 1993. In only three cases was the diagnosis of MM made clinically. In some cases histological distinction from benign Spitz naevi was difficult, but other cases were referred because of a reluctance to diagnose MM in a child. One child died of disseminated disease, two developed nodal metastases and two developed local recurrence. Of all the lesions, the one which was considered to show the least difference from a benign naevus histologically occurred in the child who died. Awareness that MM, although rare, does occur in childhood, is vital. However, diagnosis is difficult, both clinically and histopathologically.