Hatheway Marshall Emily, Alvarez Gabriella, Wang Bangchen, Crimmins Jennifer, Schneider Michelle M, Selim M Angelica, Al-Rohil Rami N
Department of Pathology, Mass General Brigham, Boston, MA 02130, USA.
Department of Internal Medicine, The University of Texas Health Sciences Center at Houston, Houston, TX 77030, USA.
Cancers (Basel). 2023 Dec 12;15(24):5804. doi: 10.3390/cancers15245804.
Atypical and malignant cutaneous tumors are understudied in the pediatric population, with limited data on long-term follow-up. This study examines pediatric (0-18 years) atypical melanocytic proliferations over a twenty-year period (January 2002-December2022) using the EPIC SlicerDicer at our institution. Over a twenty-year period, there were 55 cases of pediatric melanoma (53 patients). The median follow-up time was 8 years, 11 months. A proportion of 96% were treated with wide local excision (WLE), and 47% had a sentinel lymph node biopsy (SLNB) (35% positive rate). There were 101 atypical Spitz tumor cases (85% atypical Spitz tumors, 15% Spitz melanoma), with a median follow-up duration of 9 years. A proportion of 77% were treated with WLE (with one patient dying of metastatic disease). There were 10 cases of atypical melanocytic proliferations not otherwise specified, including 5 pigmented epithelioid melanocytomas (PEM), 4 deep-penetrating nevi, and 1 atypical cellular blue nevus. This study adds to the growing body of knowledge on pediatric atypical cutaneous melanocytic proliferations, aligning with many described characteristics such as disease location and overall survival rates, with distinct exceptions (higher melanoma positive SLNB rate, lower atypical Spitz tumor WLE rate, and a case of fatal metastatic atypical Spitz tumor).
非典型性和恶性皮肤肿瘤在儿科人群中的研究较少，长期随访数据有限。本研究使用我们机构的EPIC SlicerDicer对2002年1月至2022年12月这二十年间的儿科（0至18岁）非典型黑素细胞增生进行了研究。在这二十年间，有55例儿童黑色素瘤（53名患者）。中位随访时间为8年11个月。96%的患者接受了广泛局部切除（WLE）治疗，47%的患者进行了前哨淋巴结活检（SLNB）（阳性率为35%）。有101例非典型斯皮茨肿瘤病例（85%为非典型斯皮茨肿瘤，15%为斯皮茨黑色素瘤），中位随访时间为9年。77%的患者接受了WLE治疗（有1例患者死于转移性疾病）。有10例未另行规定的非典型黑素细胞增生病例，包括5例色素性上皮样黑素细胞瘤（PEM）、4例深部浸润性痣和1例非典型细胞性蓝痣。本研究增加了关于儿科非典型皮肤黑素细胞增生的知识体系，与许多已描述的特征如疾病部位和总生存率相符，但也有明显例外（黑色素瘤SLNB阳性率较高、非典型斯皮茨肿瘤WLE率较低以及1例致命转移性非典型斯皮茨肿瘤病例）。
