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Pediatric melanoma of the head and neck: a single institutions experience
James C French1, Mark R Rowe, T J O Lee
1Loma Linda University Children's Hospital, Division of Otolaryngology, Head and Neck Surgery, Loma Linda, California 92354, USA.
Insights
Pediatric head and neck melanoma can be effectively treated with current methods. Sentinel lymph node biopsy and interferon therapy are recommended for high-risk cases to prevent recurrence.
Area of Science:
- Oncology
- Dermatology
- Pediatric Surgery
Background:
- Melanoma in children, particularly on the head and neck, is rare.
- Effective diagnostic and treatment protocols are crucial for pediatric head and neck melanoma.
Purpose of the Study:
- To review institutional experience with pediatric head and neck melanoma.
- To discuss diagnostic protocols and propose a treatment algorithm.
Main Methods:
- Retrospective chart review of pediatric patients treated for head and neck melanoma.
- Analysis of diagnostic methods, surgical interventions, and adjuvant therapies.
Main Results:
- Six cases of pediatric head and neck melanoma identified over 25 years.
- All patients treated with wide local excision; some received sentinel lymph node biopsy and/or interferon therapy.
- No surgical complications or disease recurrence reported at the time of submission.
Conclusions:
- Pediatric head and neck melanoma is manageable with established adult treatment techniques.
- Sentinel lymph node biopsy is advised for specific diagnostic uncertainties or invasion depths.
- Adjuvant interferon alpha-2b is recommended for high-risk patients to minimize recurrence.
Objectives:
The objectives of this study were to review our experience with pediatric melanoma of the head and neck and discuss proper diagnostic protocols and suggest a possible treatment algorithm.
Study Design:
The authors conducted a retrospective chart review of patients under the age of 18 who underwent treatment for melanoma of the head and neck at a tertiary care university hospital.
Results:
Six patients were identified in the last 25 years at our institution. Four patients had melanomas in the auricle, one in the cheek, and one in the forehead. All occurrences identified presented in the past 7 years. All were treated with wide local excision. Three patients received sentinel lymph node biopsy, one received a neck dissection after identification of positive sentinel nodes, and two patients received postoperative interferon therapy. No surgical complications were reported. At the time of this submission, no patients were found to have recurrence of the disease.
Conclusions:
Pediatric melanoma of the head and neck may be managed effectively using current techniques used in treating adult patients. The use of sentinel lymph node biopsy is recommended when the depth of invasion cannot be determined from original biopsy, the original pathologic diagnosis is ambiguous, or depth of invasion from biopsy is sufficient to warrant its use. In addition, the use of adjuvant interferon alpha-2b is recommended in patients at high risk for recurrence.
