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Pampena R, Piccolo V, Muscianese M, Kyrgidis A, Lai M, Russo T, Briatico G, Di Brizzi EV, Cascone G, Pellerone S, Longo C, Moscarella E, Argenziano G. Melanoma in children: A systematic review and individual patient meta-analysis. J Eur Acad Dermatol Venereol 2023; 37:1758-1776. [PMID: 37210654 DOI: 10.1111/jdv.19220] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2022] [Accepted: 04/07/2023] [Indexed: 05/22/2023]
Abstract
The current evidence on paediatric melanoma is heterogeneous, especially regarding the prognosis of different histological subtypes. We sought to systematically review the evidence on paediatric melanoma, highlighting the major sources of heterogeneity and focusing on available data on single patients. A systematic search was performed from 1948 to 25 January 2021. Only studies reporting at least one case of cutaneous melanoma in patients aged ≤18 years were included. Unknown primary and uncertain malignant melanomas were excluded. Three couples of authors independently performed title/abstract screening and two different authors reviewed all the relevant full texts. The selected articles were manually cross-checked for overlapping data for qualitative synthesis. Subsequently data on single patients were extracted to perform a patient-level meta-analysis. PROSPERO registration number: CRD42021233248. The main outcomes were melanoma-specific survival (MSS) and progression-free survival (PFS) outcomes. Separate analyses were done of cases with complete information on histologic subtype, focusing on superficial spreading (SSM), nodular (NM) and spitzoid melanomas, as well as of those classified as de-novo (DNM) and acquired or congenital nevus-associated melanomas (NAM). The qualitative synthesis covered 266 studies; however, data on single patients were available from 213 studies including 1002 patients. Among histologic subtypes, NM had a lower MSS than both SSM and spitzoid melanoma, and a lower PFS than SSM. Spitzoid melanoma had a significantly higher progression risk than SSM and trended toward lower mortality. Focusing on nevus-associated status, DNM demonstrated better MSS after progression than congenital NAM, and no differences were highlighted in PFS. Our findings describe the existence of different biological patterns in paediatric melanoma. Specifically, spitzoid melanomas demonstrated intermediate behaviour between SSM and NM and showed a high risk of nodal progression but low mortality. This raises the question of whether spitzoid lesions are being over-diagnosed as melanoma in childhood.
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Affiliation(s)
- Riccardo Pampena
- Centro Oncologico ad Alta Tecnologia Diagnostica, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | | | | | - Athanassios Kyrgidis
- Department of Oral and Maxillofacial Surgery, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Michela Lai
- Centro Oncologico ad Alta Tecnologia Diagnostica, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Reggio Emilia, Italy
- Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy
- Clinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, Modena, Italy
| | - Teresa Russo
- Dermatology Unit, University of Campania, Naples, Italy
| | | | | | | | | | - Caterina Longo
- Centro Oncologico ad Alta Tecnologia Diagnostica, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Reggio Emilia, Italy
- Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy
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Melanoma in Iranian Childhood and Adolescence: An Analysis of 14 Patients. INTERNATIONAL JOURNAL OF CANCER MANAGEMENT 2023. [DOI: 10.5812/ijcm-121873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/12/2023]
Abstract
Background: Skin cancer is the most common cancer in Iran. Given the importance of early diagnosis in treating early tumors, knowledge of the demographic and pathological findings of the disease is helpful. Objectives: The aim of present study was to investigate the incidence, trend and risk factors of melanoma in Iranian childhood and adolescents. Methods: The present retrospective study was performed between 2005 and 2013 on registered data in the National Cancer Registry System, Iran. The age group studied was patients 18 years or younger. Data included demographic status, risk factors, clinical and histopathological characteristics, and stage. Results: The results showed that 8 (57.1%) of 14 patients were males. The mean age of the study population was 8.71 ± 6.02 years (range, 1-15 years). Ten (71.4%) patients were of Fars ethnic groups. In terms of tumor invasiveness, 13 (92.9%) patients were invasive and one (7.1%) patient was in situ. The growth phase of melanoma was vertical in 13 (92.9%) patients and radial phase in one (7.1%) patient. In terms of lymph node metastasis, it was observed in only one patient. Surgical treatment was performed on all patients. Melanoma histology was nodular in 3 patients and unspecified or unregistered in the rest. The most area of the tumor was in the head/neck and lower limbs. Conclusions: According to the results, regardless of the differences in the specific coverage of the Iranian people, the distribution and statistical characteristics of malignant melanoma in Iran are almost similar to other countries in the world. Wider studies are recommended to confirm the findings of the present study.
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de Andrade FAG, Cavalcanti CEDO, Isoldi FC, Ferreira LM. Therapeutics of xeroderma pigmentosum: A PRISMA-compliant systematic review. Indian J Dermatol Venereol Leprol 2021; 87:176-189. [PMID: 33769755 DOI: 10.25259/ijdvl_431_19] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2019] [Accepted: 02/01/2020] [Indexed: 01/13/2023]
Abstract
Xeroderma pigmentosum is a rare hereditary autosomal recessive genodermatosis. At present, there are many treatment options for xeroderma pigmentosum, covering medical/procedural, surgical and combined modalities. However, the quality of these interventions has not been assessed. Our study aimed to perform a systematic review of the literature regarding the treatment of xeroderma pigmentosum. Multiple medical databases were accessed with the Medical Subject Headings terms; "xeroderma pigmentosum," "therapeutics" and "surgical procedures, operative" from January 2000 to April 2019, including articles published in Portuguese, Spanish and English (PROSPERO-CRD42018114858). Two hundred and ninety-eight studies were found in the databases researched, of which, after applying the inclusion criteria, only 33 studies remained. The 33 complete articles were read by three of the authors, having been found: 16 reported medical/procedural and 17 reported surgical treatments. Only one clinical study presented a good level of evidence (EL: 2): a randomized clinical trial using a T4 endonuclease V (T4N5) liposome lotion which reduced the development of skin lesions in patients with xeroderma pigmentosum. Amongst surgical modalities, all studies presented low evidence level (EL: 4). Three illustrative cases are also presented, to emphasize the multiple number of times that surgical modalities may be required in these patients. The therapeutic modalities, both clinical and surgical, for xeroderma pigmentosum presented a low level of scientific evidence which did not allow meta-analysis. More therapeutic studies, both clinical and surgical, with better scientific evidence are needed.
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Santiago KM, Castro LP, Neto JPD, de Nóbrega AF, Pinto CAL, Ashton-Prolla P, Pinto E Vairo F, de Medeiros PFV, Ribeiro EM, Ribeiro BFR, do Valle FF, Doriqui MJR, Leite CHB, Rocha RM, Moura LMS, Munford V, Galante PAF, Menck CFM, Rogatto SR, Achatz MI. Comprehensive germline mutation analysis and clinical profile in a large cohort of Brazilian xeroderma pigmentosum patients. J Eur Acad Dermatol Venereol 2020; 34:2392-2401. [PMID: 32239545 DOI: 10.1111/jdv.16405] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Accepted: 03/05/2020] [Indexed: 12/21/2022]
Abstract
BACKGROUND Xeroderma pigmentosum (XP) patients present a high risk of developing skin cancer and other complications at an early age. This disease is characterized by mutations in the genes related to the DNA repair system. OBJECTIVES To describe the clinical and molecular findings in a cohort of 32 Brazilian individuals who received a clinical diagnosis of XP. METHODS Twenty-seven families were screened for germline variants in eight XP-related genes. RESULTS All patients (N = 32) were diagnosed with bi-allelic germline pathogenic or potentially pathogenic variants, including nine variants previously undescribed. The c.2251-1G>C XPC pathogenic variant, reported as the founder mutation in Comorian and Pakistani patients, was observed in 15 cases in homozygous or compound heterozygous. Seven homozygous patients for POLH/XPV variants developed their symptoms by an average age of 7.7 years. ERCC2/XPD, DDB2/XPE and ERCC5/XPG variants were found in a few patients. Aside from melanoma and non-melanoma skin tumours, a set of patients developed skin sebaceous carcinoma, leiomyosarcoma, angiosarcoma, mucoepidermoid carcinoma, gastric adenocarcinoma and serous ovarian carcinoma. CONCLUSIONS We reported a high frequency of XPC variants in 32 XP Brazilian patients. Nine new variants in XP-related genes, unexpected non-skin cancer lesions and an anticipation of the clinical manifestation in POLH/XPV cases were also described.
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Affiliation(s)
- K M Santiago
- Department of Oncogenetics, A.C.Camargo Cancer Center, São Paulo, São Paulo, Brazil.,International Research Center (CIPE), A.C.Camargo Cancer Center, São Paulo, São Paulo, Brazil
| | - L P Castro
- Department of Microbiology, Institute of Biomedical Sciences, University of Sao Paulo, São Paulo, São Paulo, Brazil
| | - J P D Neto
- Department of Skin Cancer, A.C.Camargo Cancer Center, São Paulo, São Paulo, Brazil
| | - A F de Nóbrega
- Department of Oncogenetics, A.C.Camargo Cancer Center, São Paulo, São Paulo, Brazil.,International Research Center (CIPE), A.C.Camargo Cancer Center, São Paulo, São Paulo, Brazil
| | - C A L Pinto
- Department of Pathology, A.C.Camargo Cancer Center, São Paulo, São Paulo, Brazil
| | - P Ashton-Prolla
- Medical Genetics Service, Hospital de Clínicas de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil.,Department of Genetics, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - F Pinto E Vairo
- Center for Individualized Medicine and Department of Clinical Genomics, Mayo Clinic, Rochester, MN, USA
| | - P F V de Medeiros
- University Hospital Alcides Carneiro, Federal University of Campina Grande, Campina Grande, Paraíba, Brazil
| | - E M Ribeiro
- Associação Cearense de Doenças Genéticas, Fortaleza, Ceará, Brazil
| | - B F R Ribeiro
- Children's Hospital, Secretaria de Estado de Saúde do Acre, Rio Branco, Acre, Brazil
| | - F F do Valle
- Amazonas Federal University, Manaus, Amazonas, Brazil
| | - M J R Doriqui
- Hospital Infantil Dr Juvêncio Mattos, São Luís, Maranhão, Brazil
| | - C H B Leite
- Department of Radiation Oncology, Instituto do Câncer do Ceará, Fortaleza, Ceará, Brazil
| | - R M Rocha
- Gynecology Department, Paulista Medicine School, Federal University of São Paulo (UNIFESP), São Paulo, São Paulo, Brazil
| | - L M S Moura
- Department of Microbiology, Institute of Biomedical Sciences, University of Sao Paulo, São Paulo, São Paulo, Brazil
| | - V Munford
- Department of Microbiology, Institute of Biomedical Sciences, University of Sao Paulo, São Paulo, São Paulo, Brazil
| | - P A F Galante
- Molecular Oncology Center, Hospital Sírio-Libanês, São Paulo, São Paulo, Brazil
| | - C F M Menck
- Department of Microbiology, Institute of Biomedical Sciences, University of Sao Paulo, São Paulo, São Paulo, Brazil
| | - S R Rogatto
- Department of Clinical Genetics, University Hospital, Institute of Regional Health Research, University of Southern Denmark, Vejle, Denmark
| | - M I Achatz
- Centro de Oncologia, Hospital Sírio-Libanês, São Paulo, São Paulo, Brazil
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Lam PH, Obirieze AC, Ortega G, Li BS, Purnell SD, Weeks CB, Ehanire ID, Oyetunji TA, Wilson LL. An Age-Based Analysis of Pediatric Melanoma: Staging, Surgery, and Mortality in the Surveillance, Epidemiology, and End Results Database. Am Surg 2018. [DOI: 10.1177/000313481808400528] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
The pediatric melanoma population is not well described, and current guidelines for their management are not well defined. Our study aims to identify this population, treatment modalities, and outcomes using a national population-based database. We reviewed the Surveillance, Epidemiology, and End Results database (2004–2008). Patients ≤21 years old with melanoma were included and grouped into ≤12 years of age, 13 to 18 years, and 19 to 21 years. Clinical characteristics were analyzed across the groups. A total of 1255 patients were included: 52.7 per cent were 19 to 21 years of age, 36.3 per cent were 13 to 18 years of age, and 11.0 per cent were ≤12 years of age. The 19- to 21-year-olds had the highest proportion of stage I (50.5%) versus ≤12 years of age (31.9%); the ≤12-year-olds had the highest proportion of stage IV (3.6%) versus 19 to 21 years of age (0.9%), P < 0.001. The 19- to 21-year-olds had the highest proportion receiving wide local excisions only (34.8%) versus ≤12 years of age (26.4%); the ≤12-year-olds had the highest proportion of patients without any surgeries (16.0%) versus 13 to 18 years of age (9.4%), P = 0.169. On adjusted analysis, the 19- to 21-year-olds had worse survival compared with ≤12 years of age (hazard ratio: 5.26, P = 0.017, 95% confidence interval 1.34–20.65). Disparities were found in the ≤12-year-old melanoma population, as they had later stage melanomas, less invasive surgery, and lower survival. Clearer prognostic factors are needed to better elucidate their management.
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Affiliation(s)
- Patrick H. Lam
- Howard University College of Medicine, Washington, District of Columbia
| | - Augustine C. Obirieze
- Department of Surgery, Outcomes Research Center, Howard University College of Medicine, Washington, District of Columbia
| | - Gezzer Ortega
- Department of Surgery, Outcomes Research Center, Howard University College of Medicine, Washington, District of Columbia
| | - Becky S. Li
- Howard University College of Medicine, Washington, District of Columbia
| | | | - Claudia B. Weeks
- Department of Surgery, Outcomes Research Center, Howard University College of Medicine, Washington, District of Columbia
| | - Imudia D. Ehanire
- Department of Surgery, Howard University College of Medicine, Washington, District of Columbia
| | - Tolulope A. Oyetunji
- Division of Pediatric Surgery, Department of Surgery, Children's Mercy Hospitals and Clinics, Kansas City, Missouri
| | - Lori L. Wilson
- Division of Surgical Oncology, Department of Surgery, Howard University College of Medicine, Washington, District of Columbia
- Howard University Cancer Center, Howard University Hospital, Washington, District of Columbia
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6
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Verzì AE, Bubley JA, Haugh AM, Zhang B, Wagner A, Kruse L, West DP, Wayne J, Guitart J, Gerami P. A single-institution assessment of superficial spreading melanoma (SSM) in the pediatric population: Molecular and histopathologic features compared with adult SSM. J Am Acad Dermatol 2017; 77:886-892. [PMID: 28754310 DOI: 10.1016/j.jaad.2017.05.051] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2016] [Revised: 05/26/2017] [Accepted: 05/31/2017] [Indexed: 11/22/2022]
Abstract
BACKGROUND The epidemiology of pediatric melanoma is distinct from that seen in adults. This is more distinguishable when pediatric patients are separated into prepubertal and adolescent groups. OBJECTIVE In this study, we compared epidemiologic, clinical, histologic, and molecular characteristics of pediatric superficial spreading melanoma (SSM) in prepubertal and adolescent patients to that in adults. METHOD We reviewed our database for pediatric melanomas, comparing SSM data between pediatric and adult cases for pathologic stage at presentation, ratio of radial to vertical growth phase, average Breslow depth and mitotic index, and frequency of fluorescence in situ hybridization (FISH) positivity. RESULTS Of 84 pediatric melanomas, 38 were SSM, and 5 of the latter (6%) were prepubertal. There were no significant differences when pediatric and adult SSM were compared for stage at presentation, ratio of radial to vertical growth phase, average Breslow depth and mitotic count, or frequency of FISH positivity. A significant difference was detected for SSM arising from a precursor nevus (80% of pediatric cases versus 30% of adult cases). LIMITATIONS Follow-up time was limited for both cohorts. CONCLUSIONS SSM melanoma is infrequent in childhood, particularly in the prepubertal years. Features such as tumor stage, Breslow depth, mitotic activity, and FISH positivity suggest morphologic and molecular characteristics similar to those of adult SSM.
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Affiliation(s)
- Anna Elisa Verzì
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Jeffrey A Bubley
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Alexandra M Haugh
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Bin Zhang
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Annette Wagner
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois; Ann and Robert H. Lurie Children's Hospital, Chicago, Illinois
| | - Lacey Kruse
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois; Ann and Robert H. Lurie Children's Hospital, Chicago, Illinois
| | - Dennis P West
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Jeffrey Wayne
- Department of Surgery, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Joan Guitart
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Pedram Gerami
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois; Robert H. Lurie Cancer Center, Northwestern University, Chicago, Illinois.
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Kamyab K, Kazemi S, Azimi P, Azizpour A, Ghandi N, Pirooz E, Noormohammadpour P, Mirshams-Shahshahani M, Daneshpazhooh M. Characteristic features of cutaneous melanoma in a dermatology referral centre in Tehran, Iran. Australas J Dermatol 2017; 58:e228-e231. [PMID: 28295169 DOI: 10.1111/ajd.12616] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2016] [Accepted: 12/11/2016] [Indexed: 12/29/2022]
Abstract
BACKGROUND/OBJECTIVES The characteristics of cutaneous melanoma in the Middle-Eastern countries is poorly described. Therefore we conducted this study to determine the characteristics of melanoma in Iran. METHODS A retrospective, cross sectional study of melanoma patients seen at a tertiary referral centre, Iran, from May 2004 to October 2014. Clinical data included age and gender of the patients at the time of diagnosis, tumour location and tumour size. Histological characteristics included Breslow thickness, Clark level and subtype of tumour. RESULTS A total of 450 cases of melanoma with a male/female ratio of 1.1:1 were reviewed. The mean age of patients was 57.5 years. The most frequent histological subtypes were acral lentiginous melanoma (30%) and lentigo maligna melanoma (29%). In 215 cases (49%) the tumour was located on the extremities. The second most common site was the face. Tumour invasion was mainly at Clark level III and IV. The mean Breslow thickness was 2.8 mm; 143 (38%) melanomas had a Breslow thickness less than 1 mm (T1) and 86 (23%) were more than 4 mm (T4). CONCLUSION This study indicates that clinical and histological features of melanoma in Iranians (who are mainly of skin phototypes 3-4) are different from those observed in Western countries. Further cohort studies are required to evaluate the role of ethnic and environmental risk factors for melanoma in different populations.
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Affiliation(s)
- Kambiz Kamyab
- Department of Dermatopathology, Tehran University of Medical Sciences, Tehran, Iran
| | - Sheyda Kazemi
- Department of Dermatology, Tehran University of Medical Sciences, Tehran, Iran
| | - Pourya Azimi
- Student Scientific Research Centre, Tehran University of Medical Sciences, Tehran, Iran
| | - Arghavan Azizpour
- Department of Dermatology, Tehran University of Medical Sciences, Tehran, Iran
| | - Narges Ghandi
- Department of Dermatology, Tehran University of Medical Sciences, Tehran, Iran.,Autoimmune Bullous Diseases Research Centre, Tehran University of Medical Sciences, Tehran, Iran
| | - Elham Pirooz
- Department of Dermatology, Tehran University of Medical Sciences, Tehran, Iran
| | | | | | - Maryam Daneshpazhooh
- Department of Dermatology, Tehran University of Medical Sciences, Tehran, Iran.,Autoimmune Bullous Diseases Research Centre, Tehran University of Medical Sciences, Tehran, Iran
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8
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Le Q, Norris D, McClean CA, Mcguiness M, Meani R, Kelly JW, Pan Y. Single institution experience of paediatric melanoma in Victoria, Australia. Australas J Dermatol 2016; 58:117-121. [PMID: 26821217 DOI: 10.1111/ajd.12436] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2015] [Accepted: 11/02/2015] [Indexed: 12/24/2022]
Abstract
BACKGROUND/OBJECTIVES Paediatric melanoma is an uncommon presentation of melanoma that accounts for 3% of all paediatric cancers. The objective was to describe a series of paediatric melanoma cases presenting to a state-wide tertiary referral service over the past 19 years. METHODS A search of the Victorian Melanoma Service database was performed to identify all patients under the age of 20 years diagnosed with melanoma from 1994 to 2013. Histological, demographic and phenotypical information for each patient was collected. Patients were matched against the Victorian Death Registry to identify those who had died. Fisher's exact test was used to examine associations. Melanoma-specific survival was estimated using the Kaplan-Meier method. RESULTS A total of 65 paediatric melanoma patients were included for analysis, in whom 72.3% of melanomas were diagnosed when they were 16-19 years of age with a mean age at diagnosis of 16 years. The mean Breslow thickness was 1.4 mm. It was greatest (3.4 mm) in the youngest age group (< 12 years of age). Ten patients developed nodal metastatic disease, eight of which progressed to visceral metastatic disease. The 5-year melanoma-specific survival rate was 96.8%. CONCLUSION This is the first descriptive epidemiological study of paediatric melanoma in Victoria. Further large, population-based, multi-institutional studies of paediatric melanoma are warranted to provide a clearer understanding of this group of melanoma patients.
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Affiliation(s)
- Quynh Le
- Victorian Melanoma Service, The Alfred Hospital, Melbourne, Victoria, Australia
| | - Diana Norris
- Victorian Melanoma Service, The Alfred Hospital, Melbourne, Victoria, Australia
| | - Catriona A McClean
- Victorian Melanoma Service, The Alfred Hospital, Melbourne, Victoria, Australia.,Department of Anatomical Pathology, The Alfred Hospital, Melbourne, Victoria, Australia.,Monash University, Melbourne, Victoria, Australia
| | - Myra Mcguiness
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Rowena Meani
- Victorian Melanoma Service, The Alfred Hospital, Melbourne, Victoria, Australia
| | - John W Kelly
- Victorian Melanoma Service, The Alfred Hospital, Melbourne, Victoria, Australia.,Monash University, Melbourne, Victoria, Australia
| | - Yan Pan
- Victorian Melanoma Service, The Alfred Hospital, Melbourne, Victoria, Australia
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9
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Xeroderma pigmentosum: low prevalence of germline XPA mutations in a Brazilian XP population. Int J Mol Sci 2015; 16:8988-96. [PMID: 25913378 PMCID: PMC4425119 DOI: 10.3390/ijms16048988] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2015] [Revised: 04/14/2015] [Accepted: 04/17/2015] [Indexed: 12/20/2022] Open
Abstract
Xeroderma pigmentosum (XP) is a rare autosomal recessive disorder characterized by DNA repair defects that cause photophobia, sunlight-induced cancers, and neurodegeneration. Prevalence of germline mutations in the nucleotide excision repair gene XPA vary significantly in different populations. No Brazilian patients have been reported to carry a germline mutation in this gene. In this study, the germline mutational status of XPA was determined in Brazilian patients exhibiting major clinical features of XP syndrome. The study was conducted on 27 unrelated patients from select Brazilian families. A biallelic inactivating transition mutation c.619C>T (p.Arg207Ter) was identified in only one patient with a history of neurological impairment and mild skin abnormalities. These findings suggest that XP syndrome is rarely associated with inherited disease-causing XPA mutations in the Brazilian population. Additionally, this report demonstrates the effectiveness of genotype-phenotype correlation as a valuable tool to guide direct genetic screening.
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10
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Patterson P, McDonald FEJ, Zebrack B, Medlow S. Emerging issues among adolescent and young adult cancer survivors. Semin Oncol Nurs 2014; 31:53-9. [PMID: 25636395 DOI: 10.1016/j.soncn.2014.11.006] [Citation(s) in RCA: 110] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
OBJECTIVES To review the characteristics of cancer in the adolescence and young adult age group; the medical, psychosocial and behavioral late effects; survivorship care planning and transition; current research priorities; and practice implications. DATA SOURCE Published articles, research studies and position statements. CONCLUSION Survivors of cancers that occurred during adolescence and young adulthood (AYA) are confronted with the dual demands of managing their transition to independent adulthood, concurrently with their transition from cancer patient to cancer survivors, with an associated reduction in support from medical services. AYA survivors also face complex medical, psychosocial and behavioral late effects, including fertility and mental health issues. IMPLICATIONS FOR NURSING PRACTICE An understanding of the impact of cancer diagnoses among this age group, including survivors' abilities to reintegrate into 'normal' life and potential long term consequences, is necessary to provide the best support. This care and support can be enhanced through multidisciplinary teams who work together to address the medical and psychosocial needs of AYAs diagnosed with cancer.
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11
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Bomm L, Carvalho RVD, Lima FFDS, Oliveira LNBD, Tolstoy F, Lobão D. Retrospective analysis of melanocytic lesions in children at the National Cancer Institute-RJ. An Bras Dermatol 2014; 89:369-71. [PMID: 24770528 PMCID: PMC4008082 DOI: 10.1590/abd1806-4841.20142499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2013] [Accepted: 06/03/2013] [Indexed: 11/21/2022] Open
Abstract
Skin cancer is the most common neoplasm in Brazil. Melanoma accounts for 4% of these neoplasms. Although childhood melanoma is rare, there is evidence that its incidence is increasing, placing it among the most important public health problems for the future. This work sought to conduct a retrospective review of cases of suspected melanocytic skin lesions in children, their diagnosis and management, and evaluate the sentinel lymph node biopsy method in some cases of cutaneous melanoma.
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Affiliation(s)
- Lislaine Bomm
- Instituto Nacional do Câncer, Rio de Janeiro, RJ, Brazil
| | | | | | | | | | - Dolival Lobão
- Instituto Nacional do Câncer, Rio de Janeiro, RJ, Brazil
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12
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Paradela S, Fonseca E, Pita-Fernández S, Prieto V. Spitzoid and non-spitzoid melanoma in children. A prognostic comparative study. J Eur Acad Dermatol Venereol 2012; 27:1214-21. [DOI: 10.1111/j.1468-3083.2012.04686.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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13
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Le Saché-de Peufeilhoux L, Moulonguet I, Cavelier-Balloy B, Biaggi-Frassati A, Leclerc-Mercier S, Bodemer C, Fraitag S. [Clinical features of Spitz naevus in children: a retrospective study of 196 cases]. Ann Dermatol Venereol 2012; 139:444-51. [PMID: 22721476 DOI: 10.1016/j.annder.2012.03.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2011] [Revised: 01/26/2012] [Accepted: 03/08/2012] [Indexed: 11/15/2022]
Abstract
AIMS To better define the characteristics of Spitz naevus (SN) in children, to determine whether it was clinically diagnosed and to examine the differential diagnoses made according to age. In addition, to determine whether atypical spitzoid tumors (AST) have a different presentation from other forms of SN. PATIENTS AND METHODS A two-centre retrospective survey was made of histopathological reports written over a 4-year period in children aged under 18 years. The inclusion criterion was unequivocal diagnosis of SN or AST. Age, gender, site, size, course, excision methods, presumptive clinical diagnoses and the percentage of correct diagnosis were analyzed for four distinct age groups. RESULTS One hundred and ninety-six patients were included, 186 with SN and 10 with AST. Mean age at diagnosis of SN was 9 years. Female predominance and predilection for the lower limbs were seen for all age groups. Facial involvement was less frequent and chiefly affected children aged under 11 years. Most SN lesions measured between 4 and 8mm. They were often confused with either pyogenic granuloma or juvenile xanthogranuloma, mainly before the age of 11 years. An accurate diagnosis was made in 29% of cases, chiefly in the 0 to 5 year-old age group. No cases of AST were clinically recognized, but it was diagnosed occasionally on histological grounds for very small tumours and in very young children. CONCLUSION Clinical diagnosis of SN is not always straightforward and in this study, AST exhibited no special features allowing it to be distinguished from SN. These results underline the need for caution in the event of SN in children, regardless of age or lesion size.
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Affiliation(s)
- L Le Saché-de Peufeilhoux
- Service d'anatomopathologie, hôpital Necker-Enfants Malades, Assistance publique-Hôpitaux de Paris, 149, rue de Sèvres, 75015 Paris, France
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Abstract
CONTEXT Cutaneous melanoma in childhood (CMC) is rare; therefore, its prognostic factors and biologic behavior, and the effectiveness of adjuvant techniques for CMC remain mostly unknown. OBJECTIVE To review the most useful, evidence-based practice criteria for establishing the diagnosis of CMC, for which universally accepted criteria are lacking, in order to facilitate the interpretation and comparison of the results from different institutions, and to perform systematic reviews and meta-analysis. DATA SOURCES A comprehensive review of the most relevant previous single-institution series reported in the literature since 1990, including our cumulative experience of 137 cases of primary cutaneous and mucosal melanoma in patients younger than 18 years. Special characteristics of melanoma in children are discussed, regarding clinical settings and risk factors, helpful histologic features, and immunohistochemical patterns for diagnosis and prognosis. CONCLUSIONS Careful analysis of histologic features as well as the additional information provided by immunohistochemistry should allow for a correct diagnosis in most cases of melanoma in children. Although it seems that pediatric patients with melanoma have higher survival probability than adults, still a number of children will develop metastasis and die of their disease, particularly when melanoma is diagnosed after puberty. Until further studies more accurately determine the prognosis, a prudent approach to CMC diagnosis and therapy seems to follow the same principles as those established for adult melanoma.
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Paradela S, Fonseca E, Pita-Fernández S, Kantrow SM, Diwan AH, Herzog C, Prieto VG. Prognostic factors for melanoma in children and adolescents: a clinicopathologic, single-center study of 137 Patients. Cancer 2010; 116:4334-44. [PMID: 20549825 DOI: 10.1002/cncr.25222] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND Cutaneous melanoma in childhood is rare; therefore, its prognostic factors and biologic behavior and the effectiveness of adjuvant diagnostic techniques in this group remain mostly unknown. METHODS The authors conducted a retrospective, observational study on the prognostic significance of clinical and pathologic findings from 137 cutaneous and mucosal melanomas in patients aged <18 years that were reviewed by the pathology department of a large cancer center during the period from 1992 to 2006. RESULTS Univariate analysis indicated that there was a significantly greater risk of metastases for patients who had previous nonmelanocytic malignancies, nodular histologic type, fusiform or spitzoid cytology, high Breslow thickness, vertical growth phase, high dermal mitotic activity, ulceration, and vascular invasion. Adjacent nevus and radial growth phase were associated with a better prognosis. Twelve patients (10.3%) died during follow-up. Decreased overall survival was related significantly to age >10 years, previous nonmelanocytic malignancy, high Breslow thickness, high Clark level, and the presence of metastases at diagnosis. All patients who died were aged ≥ 11 years, and 8 of those patients had metastases at diagnosis. In multivariate analysis, higher Breslow thickness predicted an increased risk of metastases, whereas age >10 years and the presence of metastases at diagnosis were associated with decreased survival. CONCLUSIONS Similar to adults, the detection of metastases at diagnosis in children with melanoma was 1 of the main factors that influenced overall survival. Melanomas that were detected in children aged <11 years appeared to have a less aggressive behavior than those detected in adults.
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Affiliation(s)
- Sabela Paradela
- Department of Dermatology, Juan Canalejo Hospital, La Coruna, Spain
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Rahnama Z, Meymandi SS, Nasiri N. Cutaneous melanoma in a desert climate zone: a retrospective study of 125 cases. Int J Dermatol 2010; 49:406-9. [PMID: 20465695 DOI: 10.1111/j.1365-4632.2010.04290.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND With increasing incidence over the last few decades, cutaneous malignant melanoma (CM) represents 3% of all skin tumors, and accounts for 75% of all deaths because of cutaneous malignancies. Little is known about the nature and epidemiology of CM in individuals with pigmented skin. METHOD Data were collected from the records of four public and private histopathology laboratories of Kerman city from March 20, 1994 to March 20, 2004. Skin biopsies with a diagnosis of CM were reevaluated to confirm the diagnosis of CM. The medical records of the patients were also taken into consideration. RESULTS A total of 125 CMs were found. The male-to-female ratio was 1.08 : 1. The mean age at the time of diagnosis was 58.9 years; with a peak in the seventh decade of life. Acral-lentiginous melanoma (ALM) represented 28.8% and; nodular melanoma occurred in 20% of cases. Limbs were the site of occurrence in 44% of tumors; whereas 36% of tumors occurred in head and neck region. There was a significant correlation between age and ALM (P = 0.007) and also between gender and melanoma types (P = 0.024). CONCLUSIONS This study indicates that some demographic and histopathologic features of CM in this population differ from those in the literature. More studies including cohort studies are needed to fully describe the nature and survival rate of CM in this area.
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Affiliation(s)
- Zahra Rahnama
- Dermatology Department, Afzalipour Hospital, Kerman Leishmania Research Center, Kerman University of Medical Sciences, Kerman, Iran.
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Bedin V, Adam RL, de Sá BC, Landman G, Metze K. Fractal dimension of chromatin is an independent prognostic factor for survival in melanoma. BMC Cancer 2010; 10:260. [PMID: 20525386 PMCID: PMC2902442 DOI: 10.1186/1471-2407-10-260] [Citation(s) in RCA: 60] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2009] [Accepted: 06/05/2010] [Indexed: 12/21/2022] Open
Abstract
Background Prognostic factors in malignant melanoma are currently based on clinical data and morphologic examination. Other prognostic features, however, which are not yet used in daily practice, might add important information and thus improve prognosis, treatment, and survival. Therefore a search for new markers is desirable. Previous studies have demonstrated that fractal characteristics of nuclear chromatin are of prognostic importance in neoplasias. We have therefore investigated whether the fractal dimension of nuclear chromatin measured in routine histological preparations of malignant melanomas could be a prognostic factor for survival. Methods We examined 71 primary superficial spreading cutaneous melanoma specimens (thickness ≥ 1 mm) from patients with a minimum follow up of 5 years. Nuclear area, form factor and fractal dimension of chromatin texture were obtained from digitalized images of hematoxylin-eosin stained tissue micro array sections. Clark's level, tumor thickness and mitotic rate were also determined. Results The median follow-up was 104 months. Tumor thickness, Clark's level, mitotic rate, nuclear area and fractal dimension were significant risk factors in univariate Cox regressions. In the multivariate Cox regression, stratified for the presence or absence of metastases at diagnosis, only the Clark level and fractal dimension of the nuclear chromatin were included as independent prognostic factors in the final regression model. Conclusion In general, a more aggressive behaviour is usually found in genetically unstable neoplasias with a higher number of genetic or epigenetic changes, which on the other hand, provoke a more complex chromatin rearrangement. The increased nuclear fractal dimension found in the more aggressive melanomas is the mathematical equivalent of a higher complexity of the chromatin architecture. So, there is strong evidence that the fractal dimension of the nuclear chromatin texture is a new and promising variable in prognostic models of malignant melanomas.
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Affiliation(s)
- Valcinir Bedin
- Department of Pathology, Faculty of Medical Sciences, University of Campinas, Campinas, SP, Brazil.
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Berk DR, LaBuz E, Dadras SS, Johnson DL, Swetter SM. Melanoma and melanocytic tumors of uncertain malignant potential in children, adolescents and young adults--the Stanford experience 1995-2008. Pediatr Dermatol 2010; 27:244-54. [PMID: 20403119 DOI: 10.1111/j.1525-1470.2009.01078.x] [Citation(s) in RCA: 78] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Pediatric melanoma is difficult to study because of its rarity, possible biological differences in preadolescents compared with adolescents, and challenges of differentiating true melanoma from atypical spitzoid neoplasms. Indeterminant lesions are sometimes designated as melanocytic tumors of uncertain malignant potential (MelTUMPs). We performed a retrospective, single-institution review of melanomas, MelTUMPs and Spitz nevi with atypical features (SNAFs) in patients at 21 years of age and younger from 1995 to 2008. We identified 13 patients with melanoma, seven with MelTUMPs, and five with SNAFs. The median age for melanoma patients was 17 years, 10 for MelTUMPs, and six for SNAFs. Of the 13 melanoma patients, only four were younger than 15 years, while six were adolescents, and three were young adults. Nine melanoma patients (69%) were female. The most common histologic subtype was superficial spreading. The median depth for melanomas was 1.2 mm, and 3.4 mm for MelTUMPs. Microscopic regional nodal involvement detected on elective or sentinel lymph node (SLN) dissection was present in 2/10 (20%) of primary melanomas and 2/6 (33%) of Mel-TUMPs. Complete lymphadenectomy was performed on four melanoma patients, with three positive cases. Patient outcome through March 31, 2009 revealed no in-transit or visceral metastasis in patients with MelTUMPs or SNAFs. One SLN-positive patient (8%) with melanoma developed recurrent lymph node and liver metastasis and died 15 months after primary diagnosis. Our data highlight the rarity, female predominance, and significant rate of SLN positivity of pediatric melanoma. The high rate of MelTUMPs with regional nodal disease reinforces the need for close follow-up.
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Affiliation(s)
- David R Berk
- Department of Dermatology, Pigmented Lesion and Melanoma Program, Stanford University Medical Center, Stanford, California 94063, USA
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Paradela S, Fernández-Torres R, Fonseca E. Controversias en el nevus congénito. ACTAS DERMO-SIFILIOGRAFICAS 2009. [DOI: 10.1016/s0001-7310(09)71903-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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McElearney ST, Dengel LT, Vaughters ABR, Patterson JW, McGahren ED, Slingluff CL. Neonatal congenital malignant melanoma with lymph node metastasis. J Clin Oncol 2009; 27:2726-8. [PMID: 19349539 PMCID: PMC5013543 DOI: 10.1200/jco.2008.20.7258] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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21
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Bhutto AM, Kirk SH. Population distribution of xeroderma pigmentosum. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2009; 637:138-43. [PMID: 19181119 DOI: 10.1007/978-0-387-09599-8_15] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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Paradela S, Fernández-Torres R, Fonseca E. Controversial Issues in Congenital Nevi. ACTAS DERMO-SIFILIOGRAFICAS 2009. [DOI: 10.1016/s1578-2190(09)70123-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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23
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Rütten A. [Malignant melanoma in children and adolescents]. DER PATHOLOGE 2007; 28:437-44. [PMID: 17874108 DOI: 10.1007/s00292-007-0938-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
According to data from the literature and to new data from the German central registry for malignant melanomas from the German Society of Dermatology, a summary is given about the occurrence of malignant melanoma in children and adolescents up to 18 years of age. During the first 10 years of life the occurrence of a melanoma is extremely rare, but slowly increases after the first decade. Several studies have shown that young people often have amelanotic tumors resembling pyogenic granuloma. This correlates with a histopathological high number of nodular melanomas in this age group. A reason might be a delay in the clinical diagnosis of malignant melanoma in children and young adults. Clinical and histopathological examples of melanoma in young people are demonstrated. Pitfalls in differential diagnosis and simulators of malignant melanoma are described and illustrated by examples of a medium sized congenital nevus with extensive intraepithelial spread of single melanocytes resembling a superficial spreading melanoma and by a compound nevus in association with a lichen sclerosus et atrophicus.
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Affiliation(s)
- A Rütten
- Dermatopathologische Gemeinschaftspraxis, Siemensstrasse 6/1, 88048, Friedrichshafen.
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Grange F, Grob JJ. Soleil, nævus et risque de mélanome. Ann Dermatol Venereol 2007. [DOI: 10.1016/s0151-9638(07)89243-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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