Atypical Spitzoid Melanocytic Tumors With Positive Sentinel Lymph Nodes in Children and Teenagers, and Comparison With Histologically Unambiguous and Lethal Melanomas
Children and teenagers with a positive sentinel lymph node (SLN) after a prior diagnosis of an atypical spitzoid melanocytic tumor (ASMT) are usually cared for clinically in the same way as patients with melanoma. Little is known about long-term follow-up of these individuals to determine whether th...
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| Veröffentlicht in: | The American journal of surgical pathology 2009-09, Vol.33 (9), p.1386-1395 |
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| container_title | The American journal of surgical pathology |
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| creator | BUSAM, Klaus J MURALI, Rajmohan KAYTON, Marc LAQUAGLIA, Michael SCOLYER, Richard A PULITZER, Melissa MCCARTHY, Stanley W THOMPSON, John F SHAW, Helen M BRADY, Mary S COIT, Daniel G DUSZA, Stephen WILMOTT, James |
| description | Children and teenagers with a positive sentinel lymph node (SLN) after a prior diagnosis of an atypical spitzoid melanocytic tumor (ASMT) are usually cared for clinically in the same way as patients with melanoma. Little is known about long-term follow-up of these individuals to determine whether this practice is appropriate. To learn more about the biology of these tumors we retrospectively reviewed the clinical and pathologic findings of children and teenagers ( |
| doi_str_mv | 10.1097/PAS.0b013e3181ac1927 |
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Little is known about long-term follow-up of these individuals to determine whether this practice is appropriate. To learn more about the biology of these tumors we retrospectively reviewed the clinical and pathologic findings of children and teenagers (<18 y of age at the time of diagnosis) with an ASMT, positive SLN and follow-up of at least 3 years. Their findings were compared with histologically unambiguous melanomas of children or teenagers, who had a positive SLN or died of metastatic melanoma. Eleven individuals, 6 girls and 5 boys, with primary ASMT and positive SLN were identified. The primary tumors ranged in thickness from 2.1 to 12 mm (median, 4.6 mm; mean, 5 mm). The tumor mitotic rate ranged from 1 to 10 mitoses/mm (median, 3/mm, median, 3/mm). The positive SLNs included 6 nodes with intranodal melanocytic aggregates measuring <1 mm in greatest dimension, and 5 nodes, in which the size of the melanocyte deposits was >/=1 mm. All the patients with ASMT and positive SLN remained free of disease with a median follow-up of 47 months (mean, 61 mo, range: 36 to 132 mo). In contrast, 2 of 5 patients <18 years of age with a histologically unambiguous melanoma and a positive SLN died of metastatic melanoma. The overall disease-specific mortality rate for all patients <18 years of age diagnosed with melanoma was 12%. Our findings confirm that children and teenagers with ASMTs and positive SLNs have a less aggressive clinical course than those with histologically unambiguous melanoma.</description><identifier>ISSN: 0147-5185</identifier><identifier>EISSN: 1532-0979</identifier><identifier>DOI: 10.1097/PAS.0b013e3181ac1927</identifier><identifier>PMID: 19609204</identifier><identifier>CODEN: AJSPDX</identifier><language>eng</language><publisher>Hagerstown, MD: Lippincott Williams & Wilkins</publisher><subject>Adolescent ; Biological and medical sciences ; Child ; Dermatology ; Disease-Free Survival ; Female ; Hematologic and hematopoietic diseases ; Humans ; Investigative techniques, diagnostic techniques (general aspects) ; Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis ; Male ; Medical sciences ; Melanoma - secondary ; Melanoma - surgery ; Nevus, Epithelioid and Spindle Cell - pathology ; Nevus, Epithelioid and Spindle Cell - surgery ; Pathology. Cytology. Biochemistry. Spectrometry. Miscellaneous investigative techniques ; Sentinel Lymph Node Biopsy ; Skin Neoplasms - pathology ; Skin Neoplasms - surgery ; Tumors of the skin and soft tissue. Premalignant lesions</subject><ispartof>The American journal of surgical pathology, 2009-09, Vol.33 (9), p.1386-1395</ispartof><rights>2009 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c335t-45c6ca7ff41626c415a75cf7c45e4bf7a6fab360c90d81c35825abe1e1fb85383</citedby><cites>FETCH-LOGICAL-c335t-45c6ca7ff41626c415a75cf7c45e4bf7a6fab360c90d81c35825abe1e1fb85383</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=21878577$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/19609204$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>BUSAM, Klaus J</creatorcontrib><creatorcontrib>MURALI, Rajmohan</creatorcontrib><creatorcontrib>KAYTON, Marc</creatorcontrib><creatorcontrib>LAQUAGLIA, Michael</creatorcontrib><creatorcontrib>SCOLYER, Richard A</creatorcontrib><creatorcontrib>PULITZER, Melissa</creatorcontrib><creatorcontrib>MCCARTHY, Stanley W</creatorcontrib><creatorcontrib>THOMPSON, John F</creatorcontrib><creatorcontrib>SHAW, Helen M</creatorcontrib><creatorcontrib>BRADY, Mary S</creatorcontrib><creatorcontrib>COIT, Daniel G</creatorcontrib><creatorcontrib>DUSZA, Stephen</creatorcontrib><creatorcontrib>WILMOTT, James</creatorcontrib><title>Atypical Spitzoid Melanocytic Tumors With Positive Sentinel Lymph Nodes in Children and Teenagers, and Comparison With Histologically Unambiguous and Lethal Melanomas</title><title>The American journal of surgical pathology</title><addtitle>Am J Surg Pathol</addtitle><description>Children and teenagers with a positive sentinel lymph node (SLN) after a prior diagnosis of an atypical spitzoid melanocytic tumor (ASMT) are usually cared for clinically in the same way as patients with melanoma. Little is known about long-term follow-up of these individuals to determine whether this practice is appropriate. To learn more about the biology of these tumors we retrospectively reviewed the clinical and pathologic findings of children and teenagers (<18 y of age at the time of diagnosis) with an ASMT, positive SLN and follow-up of at least 3 years. Their findings were compared with histologically unambiguous melanomas of children or teenagers, who had a positive SLN or died of metastatic melanoma. Eleven individuals, 6 girls and 5 boys, with primary ASMT and positive SLN were identified. The primary tumors ranged in thickness from 2.1 to 12 mm (median, 4.6 mm; mean, 5 mm). The tumor mitotic rate ranged from 1 to 10 mitoses/mm (median, 3/mm, median, 3/mm). The positive SLNs included 6 nodes with intranodal melanocytic aggregates measuring <1 mm in greatest dimension, and 5 nodes, in which the size of the melanocyte deposits was >/=1 mm. All the patients with ASMT and positive SLN remained free of disease with a median follow-up of 47 months (mean, 61 mo, range: 36 to 132 mo). In contrast, 2 of 5 patients <18 years of age with a histologically unambiguous melanoma and a positive SLN died of metastatic melanoma. The overall disease-specific mortality rate for all patients <18 years of age diagnosed with melanoma was 12%. Our findings confirm that children and teenagers with ASMTs and positive SLNs have a less aggressive clinical course than those with histologically unambiguous melanoma.</description><subject>Adolescent</subject><subject>Biological and medical sciences</subject><subject>Child</subject><subject>Dermatology</subject><subject>Disease-Free Survival</subject><subject>Female</subject><subject>Hematologic and hematopoietic diseases</subject><subject>Humans</subject><subject>Investigative techniques, diagnostic techniques (general aspects)</subject><subject>Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Melanoma - secondary</subject><subject>Melanoma - surgery</subject><subject>Nevus, Epithelioid and Spindle Cell - pathology</subject><subject>Nevus, Epithelioid and Spindle Cell - surgery</subject><subject>Pathology. Cytology. Biochemistry. Spectrometry. Miscellaneous investigative techniques</subject><subject>Sentinel Lymph Node Biopsy</subject><subject>Skin Neoplasms - pathology</subject><subject>Skin Neoplasms - surgery</subject><subject>Tumors of the skin and soft tissue. 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Malignant lymphomas. Malignant reticulosis. Myelofibrosis</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Melanoma - secondary</topic><topic>Melanoma - surgery</topic><topic>Nevus, Epithelioid and Spindle Cell - pathology</topic><topic>Nevus, Epithelioid and Spindle Cell - surgery</topic><topic>Pathology. Cytology. Biochemistry. Spectrometry. Miscellaneous investigative techniques</topic><topic>Sentinel Lymph Node Biopsy</topic><topic>Skin Neoplasms - pathology</topic><topic>Skin Neoplasms - surgery</topic><topic>Tumors of the skin and soft tissue. 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Little is known about long-term follow-up of these individuals to determine whether this practice is appropriate. To learn more about the biology of these tumors we retrospectively reviewed the clinical and pathologic findings of children and teenagers (<18 y of age at the time of diagnosis) with an ASMT, positive SLN and follow-up of at least 3 years. Their findings were compared with histologically unambiguous melanomas of children or teenagers, who had a positive SLN or died of metastatic melanoma. Eleven individuals, 6 girls and 5 boys, with primary ASMT and positive SLN were identified. The primary tumors ranged in thickness from 2.1 to 12 mm (median, 4.6 mm; mean, 5 mm). The tumor mitotic rate ranged from 1 to 10 mitoses/mm (median, 3/mm, median, 3/mm). The positive SLNs included 6 nodes with intranodal melanocytic aggregates measuring <1 mm in greatest dimension, and 5 nodes, in which the size of the melanocyte deposits was >/=1 mm. All the patients with ASMT and positive SLN remained free of disease with a median follow-up of 47 months (mean, 61 mo, range: 36 to 132 mo). In contrast, 2 of 5 patients <18 years of age with a histologically unambiguous melanoma and a positive SLN died of metastatic melanoma. The overall disease-specific mortality rate for all patients <18 years of age diagnosed with melanoma was 12%. Our findings confirm that children and teenagers with ASMTs and positive SLNs have a less aggressive clinical course than those with histologically unambiguous melanoma.</abstract><cop>Hagerstown, MD</cop><pub>Lippincott Williams & Wilkins</pub><pmid>19609204</pmid><doi>10.1097/PAS.0b013e3181ac1927</doi><tpages>10</tpages></addata></record> |
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| identifier | ISSN: 0147-5185 |
| ispartof | The American journal of surgical pathology, 2009-09, Vol.33 (9), p.1386-1395 |
| issn | 0147-5185 1532-0979 |
| language | eng |
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| source | MEDLINE; Journals@Ovid Complete |
| subjects | Adolescent Biological and medical sciences Child Dermatology Disease-Free Survival Female Hematologic and hematopoietic diseases Humans Investigative techniques, diagnostic techniques (general aspects) Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis Male Medical sciences Melanoma - secondary Melanoma - surgery Nevus, Epithelioid and Spindle Cell - pathology Nevus, Epithelioid and Spindle Cell - surgery Pathology. Cytology. Biochemistry. Spectrometry. Miscellaneous investigative techniques Sentinel Lymph Node Biopsy Skin Neoplasms - pathology Skin Neoplasms - surgery Tumors of the skin and soft tissue. Premalignant lesions |
| title | Atypical Spitzoid Melanocytic Tumors With Positive Sentinel Lymph Nodes in Children and Teenagers, and Comparison With Histologically Unambiguous and Lethal Melanomas |
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