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[Sentinel lymph node in children with melanoma--case report].
Renato Santos de Oliveira Filho1, Geruza Rezende Paiva, Lydia M Ferreira
1Cirurgia Plástica, Medicina, Universidade Federal de São Paulo, SP.
Jornal De Pediatria
|December 4, 2003
Summary
Sentinel lymph node biopsy is a viable option for pediatric cutaneous melanoma, even with positive tyrosinase mRNA detection. This approach aids in staging and management of rare childhood melanoma cases.
Area of Science:
- Pediatric Oncology
- Dermatology
- Surgical Pathology
Context:
- Childhood melanoma is a rare malignancy, accounting for less than 1% of pediatric cancers.
- Increasing incidence worldwide necessitates refined diagnostic and staging strategies.
- Melanoma can arise from existing nevi or *de novo*, emphasizing the need for vigilance.
Purpose:
- To present a case of sentinel lymph node biopsy (SLNB) in a pediatric patient diagnosed with cutaneous melanoma.
- To evaluate the utility of SLNB in staging and guiding treatment for childhood melanoma.
- To highlight the role of molecular markers in assessing nodal involvement.
Summary:
- A 12-year-old child with Dysplastic Nevus Syndrome was diagnosed with lumbar cutaneous melanoma (1.5 mm depth).
- The patient underwent wide excision and sentinel lymph node biopsy; histopathology was negative for metastasis.
- Reverse transcription-polymerase chain reaction (RT-PCR) for tyrosinase mRNA was positive, indicating sub-microscopic disease.
- The patient remains recurrence-free at 12-month follow-up.
Impact:
- Sentinel lymph node biopsy is a valuable tool for staging pediatric melanoma, potentially avoiding complete lymphadenectomy.
- Positive RT-PCR for tyrosinase mRNA suggests sub-visual metastatic potential, warranting close surveillance.
- This case supports the application of SLNB in managing rare but aggressive childhood melanomas.