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Malignant melanoma in children: imaging spectrum
S C Kaste1, A S Pappo, J J Jenkins
1Department of Diagnostic Imaging, St. Jude Children's Research Hospital, 332 N. Lauderdale, P. O. Box 318, Memphis, TN 38101-0318, USA.
Pediatric Radiology
|November 1, 1996
Summary
Diagnostic imaging detected unsuspected metastases in 25% of pediatric melanoma patients. Children with deep lesions or unknown primary tumors require CT scans to assess disease extent.
Area of Science:
- Pediatric Oncology
- Medical Imaging
- Dermatology
Background:
- Malignant melanoma in children is rare but can present with metastatic disease.
- The role of diagnostic imaging in detecting occult metastases in pediatric melanoma is not well-established.
Purpose of the Study:
- To investigate the utility of diagnostic imaging in identifying unsuspected metastatic disease in pediatric melanoma patients.
- To correlate imaging findings with clinical and pathological features of pediatric melanoma.
Main Methods:
- Retrospective analysis of 33 children diagnosed with melanoma.
- Correlation of diagnostic imaging findings with tumor invasion depth (Clark's level) and clinical stage.
- Review of computed tomography (CT) scans of the chest, abdomen, and nodal basins.
Main Results:
- Clinically undetectable metastases were identified in 8 patients (25%).
- Four of these patients had multiple metastases.
- All patients with detected metastases had deep lesions (Clark's level IV or V) or unknown primary tumor sites.
Conclusions:
- Diagnostic imaging, particularly CT scans, is crucial for detecting unsuspected metastases in pediatric melanoma.
- Children with thick melanomas (Clark's level IV/V) or unknown primary sites are at higher risk.
- Early CT imaging of the chest, abdomen, and nodal basins is recommended at diagnosis to determine the full extent of disease in at-risk pediatric melanoma patients.