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.