title: Reliability of the histopathologic diagnosis of malignant melanoma in childhood.
abstract: 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.
authors.affiliation: Department of Pathology, Henri-Mondor Hospital, F-94010 Créteil CEDEX, France.
authors.forename: Janine
authors.initials: J
authors.lastname: Wechsler
authors.forename: Sylvie
authors.initials: S
authors.lastname: Bastuji-Garin
authors.forename: Alain
authors.initials: A
authors.lastname: Spatz
authors.forename: Christiane
authors.initials: C
authors.lastname: Bailly
authors.forename: Bernard
authors.initials: B
authors.lastname: Cribier
authors.forename: Lucile
authors.initials: L
authors.lastname: Andrac-Meyer
authors.forename: Béatrice
authors.initials: B
authors.lastname: Vergier
authors.forename: Sylvie
authors.initials: S
authors.lastname: Fraitag
authors.forename: Olivier
authors.initials: O
authors.lastname: Verola
authors.forename: Pierre
authors.initials: P
authors.lastname: Wolkenstein
mesh_terms: 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*