Reliability of the histopathologic diagnosis of malignant melanoma in childhood.
OBJECTIVE
To assess interrater reliability in the diagnosis of malignant melanoma in children.


METHODS
We collected 85 slides of melanomas diagnosed in patients younger than 17 years through a network of dermatopathologists and dermatologists. The slides were classified into 3 categories: (1) slides from children with metastatic melanoma; (2) slides from disease-free children with a follow-up of less than 5 years; (3) slides from disease-free children with a follow-up of 5 years or longer. Category 1 was considered the gold standard. Four pairs of expert dermatopathologists reviewed the slides and classified them into melanoma, nevus (including Spitz nevus), or ambiguous tumors.


METHODS
None.


METHODS
Concordance between pairs of experts.


RESULTS
For category 1 slides (n = 20), the concordance was weak to moderate. For category 2 slides (n = 47), the concordance was weak. For category 3 slides (n = 18), the concordance was poor to moderate.


CONCLUSIONS
This study demonstrates that the reliability of diagnosis of melanoma in childhood is poor, even when submitted to experts.
Wechsler
Janine
J
Department of Pathology, Henri-Mondor Hospital, F-94010 Créteil CEDEX, France.
Bastuji-Garin
Sylvie
S
Spatz
Alain
A
Bailly
Christiane
C
Cribier
Bernard
B
Andrac-Meyer
Lucile
L
Vergier
Béatrice
B
Fraitag
Sylvie
S
Verola
Olivier
O
Wolkenstein
Pierre
P
D000293:Adolescent; D002648:Child; D003880:Dermatology / Q000592:standards; D006801:Humans; D008545:Melanoma / Q000473:pathology*; D009362:Neoplasm Metastasis; D009506:Nevus / Q000473:pathology; D015588:Observer Variation; D010338:Pathology, Clinical / Q000592:standards; D012878:Skin Neoplasms / Q000473:pathology*