Patients Characteristics
Twenty-three patients (median age: 13 years, age range: 2-20 years) were
diagnosed with melanoma with the following histopathologic subtypes:
Spitzoid melanoma (5), melanoma in situ (3), superficial spreading
melanoma (2), nevoid melanoma (1), nodular melanoma (1), severely
atypical spindle cell melanocytic tumor (1), and pigmented epithelioid
melanocytoma (1). In 9 cases, a conventional histopathologic subtype was
not reported. Melanoma staging ranged from Stage 0 to Stage IIIC. Tumor
genetic testing was performed on 10 patients. All patients received wide
local excision (WLE) as initial treatment at the University of Rochester
Medical Center between 2011 and 2022 (Table 1). Breslow thickness was
reported in 17/23 patients and ranged from 0.5 mm to 7.8 mm. The
melanomas were found at the following locations foot (2), leg (4), arm
(2), hand (3), shoulder (2), head (3), back (4), axilla (1), flank (1)
and buttock (1).
Six patients (26%) self-reported a history of sunburns that was
documented in their electronic medical record and 5 patients (21.7%)
reported a family history of melanoma (Table 2). Twelve patients (52%)
presented for evaluation due to changes in their pre-existing “moles”
(melanocytic nevi) with 8 reporting increasing size, 5 reporting changes
in color and 2 reporting bleeding. Melanoma arose de novo in 9 patients
(39.1%), from congenital melanocytic nevi (CMN) in 3 patients (13%),
and from acquired melanocytic nevi in 2 patients (8.7%). The origin of
melanomas in 9 (39.1%) patients was not mentioned or was unable to be
categorized based on histopathology and patient presentation.