Sentinel node biopsy in atypical melanocytic neoplasms in childhood: a single institution experience in 24 patients
Article first published online: 16 FEB 2012
Copyright © 2012 John Wiley & Sons A/S
Journal of Cutaneous Pathology
Volume 39, Issue 3, pages 331–336, March 2012
How to Cite
Mills, O. L., Marzban, S., Zager, J. S., Sondak, V. K. and Messina, J. L. (2012), Sentinel node biopsy in atypical melanocytic neoplasms in childhood: a single institution experience in 24 patients. Journal of Cutaneous Pathology, 39: 331–336. doi: 10.1111/j.1600-0560.2011.01853.x
- Issue published online: 16 FEB 2012
- Article first published online: 16 FEB 2012
- Accepted for publication July 12, 2011
- atypical melanocytic neoplasm;
- atypical Spitz nevus;
- sentinel lymph node;
- spitzoid neoplasm
Introduction: Sentinel lymph node biopsy (SLNB) is a controversial but frequently used adjunct to wide excision of difficult-to-diagnose melanocytic proliferations of childhood. We herein report our institutional experience with SLNB in pediatric patients with these lesions, hereafter referred to as ‘atypical melanocytic proliferations'.
Methods: Our prospectively collected melanoma database was queried for patients ≤21 years of age status post-SLNB for a diagnosis of atypical melanocytic proliferation in which the diagnosis of melanoma ≥1 mm in depth was considered in the differential diagnosis by one or more expert dermatopathologists and for which no diagnostic consensus could be reached.
Results: Of 24 patients identified over 17 years, 7 patients (29%) had a positive sentinel lymph node (SLN). Six SLN-positive patients underwent complete lymph node dissection, with one (14%) having additional nodal involvement identified. With a median follow-up of 4.1 years (range < 0.1 to 14.8 years), all patients showed no evidence of disease.
Conclusions: Despite a significant rate of identification of melanocytes in SLNs of children with atypical melanocytic proliferations, survival appears favorable and controversy surrounding the significance of nodal involvement remains. Further studies with larger numbers of patients and long-term follow-up are needed before the true prognostic value of SLNB in this setting can be determined.
Mills OL, Marzban S, Zager JS, Sondak VK, Messina JL. Sentinel node biopsy in atypical melanocytic neoplasms in childhood: a single institution experience in 24 patients.