Lambie Milena, Nadler Chad, Glat Paul, Van Duzer Scott, Halligan Gregory, Geller Evan
Department of Plastic Surgery, Philadelphia College of Osteopathic Medicine, Philadelphia, PA, USA.
Ann Plast Surg. 2011 Jul;67(1):85-9. doi: 10.1097/SAP.0b013e3181e0fcbc.
Cases of infantile melanoma are very rare, and only a few have been presented in the literature. Pediatric melanoma can present to the clinician as a "triple threat" of delayed diagnosis resulting in thick lesions at risk for metastasis, histologic uncertainty of diagnosis, and a lack of data guiding regional node management and adjuvant therapy. Melanoma in childhood is an uncommon condition, and it is even more atypical in infants. There is evidence however that it is increasing in frequency. We present 2 cases of infantile melanoma diagnosed before age 1 and multidisciplinary management performed at our institution. One child was diagnosed with melanoma arising within a congenital melanocytic nevus, and the other presented with melanoma from a de novo acquired scalp lesion. The ambiguity surrounding correct pathologic diagnosis of melanoma in this age group, and the tendency for late diagnosis with thicker lesions presents special staging and treatment challenges to the team of specialists involved in the care of these children.
婴儿黑色素瘤病例非常罕见，文献中仅报道过少数几例。小儿黑色素瘤可能会给临床医生带来“三重威胁”，即诊断延迟导致病灶增厚而有转移风险、组织学诊断存在不确定性，以及缺乏指导区域淋巴结管理和辅助治疗的数据。儿童黑色素瘤并不常见，在婴儿中更为罕见。然而，有证据表明其发病率正在上升。我们报告了2例1岁前诊断的婴儿黑色素瘤病例以及在我们机构进行的多学科管理情况。其中一名儿童被诊断为先天性黑素细胞痣内发生的黑色素瘤，另一名则表现为新发头皮病变引发的黑色素瘤。这个年龄组黑色素瘤正确病理诊断的不确定性，以及因诊断延迟导致病灶较厚的趋势，给参与这些儿童护理的专家团队带来了特殊的分期和治疗挑战。
