Win J Tcheung1, Jennifer E Marcello2, Puja K Puri3, Amy P Abernethy4, Kelly C Nelson5. 1. Duke University Medical Center, Department of Dermatology, Durham, North Carolina. 2. Duke University Medical Center, Department of Cancer Center Biostatistics, Durham, North Carolina. 3. Duke University Medical Center, Department of Dermatopathology, Durham, North Carolina. 4. Duke University Medical Center, Department of Medical Oncology, Durham, North Carolina. 5. Duke University Medical Center, Department of Dermatology, Durham, North Carolina. Electronic address: kelly.nelson@duke.edu.
Abstract
BACKGROUND: Studies examining head and neck (H&N) melanoma in the pediatric population are scarce. OBJECTIVE: The goal of this study is to describe pediatric H&N melanoma with the intent of increasing understanding of the course of disease. METHODS: The Duke Melanoma Database and Duke Tumor Registry Database were searched for patients with a diagnosis of melanoma occurring on the H&N before age 18 years, with exclusion of ocular/mucosal/aerodigestive melanomas. RESULTS: Queries yielded 39 Caucasian pediatric patients, 24 (61.5%) of them male. The mean age at diagnosis was 14.2 years (15 years, median). The primary sites were represented as follows: cutaneous auricular (1/39, 2.6%), facial (15/39, 38.5%), and scalp/neck (23/39, 59%). The follow-up time ranged from 2 months to 23 years with a median of 9.9 years (95% confidence interval: 6.2-13 years). At the time of follow-up, there were 12 (12/39, 30.8%) melanoma-associated deaths. The anatomic distribution of primary melanoma for these 12 patients follows: 4 (33.3%) facial and 8 (66.7%) scalp/neck. Histologic data revealed 24 (61.5%) tumors classified as superficial spreading melanoma with nodular melanoma (12.8%) a distant second. The mean Breslow depth for patients with melanoma-related mortality was 2.4 mm, compared with 1.8 mm for those who were alive at last follow-up. LIMITATIONS: Small sample size limited this study. CONCLUSION: This study found that the majority (59%) of H&N melanomas presented as scalp or neck lesions with a predilection for adolescents and boys. Those who experienced melanoma-related mortality had thicker lesions. Superficial spreading melanoma was the most common subtype.
BACKGROUND: Studies examining head and neck (H&N) melanoma in the pediatric population are scarce. OBJECTIVE: The goal of this study is to describe pediatric H&N melanoma with the intent of increasing understanding of the course of disease. METHODS: The Duke Melanoma Database and Duke Tumor Registry Database were searched for patients with a diagnosis of melanoma occurring on the H&N before age 18 years, with exclusion of ocular/mucosal/aerodigestive melanomas. RESULTS: Queries yielded 39 Caucasian pediatric patients, 24 (61.5%) of them male. The mean age at diagnosis was 14.2 years (15 years, median). The primary sites were represented as follows: cutaneous auricular (1/39, 2.6%), facial (15/39, 38.5%), and scalp/neck (23/39, 59%). The follow-up time ranged from 2 months to 23 years with a median of 9.9 years (95% confidence interval: 6.2-13 years). At the time of follow-up, there were 12 (12/39, 30.8%) melanoma-associated deaths. The anatomic distribution of primary melanoma for these 12 patients follows: 4 (33.3%) facial and 8 (66.7%) scalp/neck. Histologic data revealed 24 (61.5%) tumors classified as superficial spreading melanoma with nodular melanoma (12.8%) a distant second. The mean Breslow depth for patients with melanoma-related mortality was 2.4 mm, compared with 1.8 mm for those who were alive at last follow-up. LIMITATIONS: Small sample size limited this study. CONCLUSION: This study found that the majority (59%) of H&N melanomas presented as scalp or neck lesions with a predilection for adolescents and boys. Those who experienced melanoma-related mortality had thicker lesions. Superficial spreading melanoma was the most common subtype.
Authors: K T Huynh; Y Takei; C Kuo; R A Scolyer; R Murali; K Chong; L Takeshima; M-S Sim; D L Morton; R R Turner; J F Thompson; D S B Hoon Journal: Br J Dermatol Date: 2012-05-18 Impact factor: 9.302