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A retrospective multicenter study of fatal pediatric melanoma - 10/10/20

Doi : 10.1016/j.jaad.2020.06.1010 
Elena B. Hawryluk, MD, PhD a, b, c, , Danna Moustafa, BS a, b, Diana Bartenstein, MD a, b, c, Meera Brahmbhatt, MD d, Kelly Cordoro, MD e, f, Laura Gardner, MD g, Abigail Gauthier, BS h, Douglas Grossman, MD, PhD g, i, Deepti Gupta, MD j, k, Raegan D. Hunt, MD, PhD l, m, Melinda Jen, MD n, o, Pei-Chi Kao, MPH a, c, p, Lacey L. Kruse, MD q, r, Leslie P. Lawley, MD d, Wendy B. London, PhD a, c, p, Danny Mansour, MD s, t, Judith A. O'Haver, PhD, RN u, Thuy Phung, MD, PhD l, m, Elena Pope, MD, MSc s, t, Harper N. Price, MD u, Tova Rogers, MD v, Sonal D. Shah, MD e, f, Zachary Wolner, MD v, Jennifer Huang, MD a, c, Ashfaq A. Marghoob, MD v
a Harvard Medical School, Boston, Massachusetts 
b Department of Dermatology, Massachusetts General Hospital, Boston, Massachusetts 
c Boston Children's Hospital, Boston, Massachusetts 
d Emory University School of Medicine, Department of Dermatology, Atlanta, Georgia 
e University of California–San Francisco Benioff Children's Hospital, San Francisco, California 
f Department of Dermatology, University of California, San Francisco, San Francisco, California 
g Department of Dermatology, University of Utah School of Medicine, Salt Lake City, Utah 
h University of Alabama at Birmingham School of Medicine, Birmingham, Alabama 
i Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah 
j Department of Dermatology, Seattle Children's Hospital, Seattle, Washington 
k University of Washington School of Medicine, Seattle, Washington 
l Department of Dermatology, Texas Children's Hospital, Houston, Texas 
m Baylor College of Medicine, Houston, Texas 
n Department of Dermatology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania 
o Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania 
p Dana-Farber Cancer Institute, Boston, Massachusetts 
q Department of Dermatology, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois 
r Northwestern University Feinberg School of Medicine, Chicago, Illinois 
s The Hospital for Sick Children, Toronto, Canada 
t University of Toronto, Toronto, Canada 
u Phoenix Children's Hospital, Department of Dermatology, Phoenix, Arizona 
v Dermatology Service, Department of Medicine, Memorial Sloan Kettering Skin Cancer Center, New York, New York 

Reprint requests: Elena B. Hawryluk, MD, PhD, Department of Dermatology, Massachusetts General Hospital, 50 Staniford St, Boston, MA 02114.Department of DermatologyMassachusetts General Hospital50 Staniford StBostonMA02114

Abstract

Background

Pediatric melanoma is rare and diagnostically challenging.

Objective

To characterize clinical and histopathologic features of fatal pediatric melanomas.

Methods

Multicenter retrospective study of fatal melanoma cases in patients younger than 20 years diagnosed between 1994 and 2017.

Results

Of 38 cases of fatal pediatric melanoma identified, 57% presented in white patients and 19% in Hispanic patients. The average age at diagnosis was 12.7 years (range, 0.0-19.9 y), and the average age at death was 15.6 years (range, 1.2-26.2 y). Among cases with known identifiable subtypes, 50% were nodular (8/16), 31% were superficial spreading (5/16), and 19% were spitzoid melanoma (3/16). One fourth (10/38) of melanomas arose in association with congenital melanocytic nevi.

Limitations

Retrospective nature, cohort size, and potential referral bias.

Conclusions

Pediatric melanoma can be fatal in diverse clinical presentations, including a striking prevalence of Hispanic patients compared to adult disease, and with a range of clinical subtypes, although no fatal cases of spitzoid melanoma were diagnosed during childhood.

Le texte complet de cet article est disponible en PDF.

Key words : melanoma, oncology, pediatric dermatology, pediatric melanoma

Abbreviations used : CMN, FISH, LVI, SD, SLNB


Plan


 Funding sources: Supported by a 2019 Pediatric Dermatology Research Alliance Study Support Grant and 2017 Society for Pediatric Dermatology Pediatric Dermatology Research Alliance Pilot Award. Dr Hawryluk is supported by the Dermatology Foundation and the Harvard Medical School Eleanor and Miles Shore Fellowship Award.
 Conflicts of interest: None disclosed.
 This work was previously presented at the 2019 Pediatric Dermatology Research Alliance Annual Meeting in Chicago, IL, November 15, 2019.
 IRB approval status: Reviewed and approved by Dana-Farber Cancer Institute IRB 15-156 as the central IRB and also approved by the IRBs at all collaborating institutions per regulations at the time of study initiation.


© 2020  American Academy of Dermatology, Inc.. Publié par Elsevier Masson SAS. Tous droits réservés.
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