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Sentinel node biopsy in atypical melanocytic neoplasms in childhood: a single institution experience in 24 patients

Authors

  • Omie L. Mills,

    1. Department of Pathology and Cell Biology, College of Medicine, University of South Florida, Tampa, FL, USA
    2. Department of Dermatology, University of Massachusetts, Worcester, MA, USA
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  • Suroosh Marzban,

    1. Department of Cutaneous Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
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  • Jonathan S. Zager,

    1. Department of Cutaneous Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
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  • Vernon K. Sondak,

    1. Department of Cutaneous Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
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  • Jane L. Messina

    Corresponding author
    1. Department of Pathology and Cell Biology, College of Medicine, University of South Florida, Tampa, FL, USA
    2. Department of Cutaneous Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
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Jane L. Messina, MD, Department of Pathology and Cell Biology, College of Medicine, University of South Florida, 12901 Bruce B Downs Blvd., MDC 1
Tampa, FL 33612, USA
Tel: +813 974 3133
Fax: +813 974 0337
e-mail: jmessina@health.usf.edu

Abstract

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.

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