Clinical features and outcomes of spitzoid proliferations in children and adolescents.
Br J Dermatol
; 181(2): 366-372, 2019 08.
Article
in En
| MEDLINE
| ID: mdl-30467833
ABSTRACT
BACKGROUND:
Spitzoid proliferations range from Spitz naevi to melanomas. There are few studies describing clinical features and outcomes in the paediatric population.OBJECTIVES:
To determine the clinical features and outcomes of a large paediatric cohort with histopathologically confirmed Spitz tumours.METHODS:
This was a retrospective cohort study of patients seen at Boston Children's Hospital who were aged < 20 years and had a histopathological diagnosis of spitzoid proliferation from 1 January 1994 to 23 October 2012.RESULTS:
In total 595 patients with 622 spitzoid proliferations were identified (median age 7·4 years, interquartile range 4·6-11·7). Overall 512 proliferations (82·3%) were typical, 107 (17·2.%) were atypical and three (0·5%) were melanomas. The median ages at biopsy were 7·4, 7·2 and 17·2 years, respectively, and there was a significant difference in age at biopsy for patients with typical or atypical proliferations vs. melanoma (P < 0·01). Among samples with positive margins (n = 153), 55% (54 of 98) of typical proliferations, 77% (41 of 53) of atypical proliferations and 100% (two of two) of melanomas were re-excised. Six patients had sentinel lymph node biopsy performed, with three patients demonstrating nodes positive for melanocytic cells. Within a median follow-up of 4·1 years for the full cohort there were no related deaths.CONCLUSIONS:
Spitz tumours have strikingly benign outcomes in the paediatric population, although this study is limited by the low number of melanomas and restriction to a single paediatric institution. Aggressive management recommendations should be reconsidered for children and adolescents with banal-appearing Spitz naevi, based on the clinically indolent behaviour in this cohort.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Skin
/
Skin Neoplasms
/
Nevus, Epithelioid and Spindle Cell
/
Melanoma
Type of study:
Diagnostic_studies
/
Guideline
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limits:
Adolescent
/
Adult
/
Child
/
Child, preschool
/
Female
/
Humans
/
Male
Language:
En
Journal:
Br J Dermatol
Year:
2019
Document type:
Article
Affiliation country:
United States