title: Evaluation of 39 cases of pediatric cutaneous head and neck melanoma.
abstract: BACKGROUND
  Studies examining head and neck (H&N) melanoma in the pediatric population are scarce.
  
  
  OBJECTIVE
  The goal of this study is to describe pediatric H&N melanoma with the intent of increasing understanding of the course of disease.
  
  
  METHODS
  The Duke Melanoma Database and Duke Tumor Registry Database were searched for patients with a diagnosis of melanoma occurring on the H&N before age 18 years, with exclusion of ocular/mucosal/aerodigestive melanomas.
  
  
  RESULTS
  Queries yielded 39 Caucasian pediatric patients, 24 (61.5%) of them male. The mean age at diagnosis was 14.2 years (15 years, median). The primary sites were represented as follows: cutaneous auricular (1/39, 2.6%), facial (15/39, 38.5%), and scalp/neck (23/39, 59%). The follow-up time ranged from 2 months to 23 years with a median of 9.9 years (95% confidence interval: 6.2-13 years). At the time of follow-up, there were 12 (12/39, 30.8%) melanoma-associated deaths. The anatomic distribution of primary melanoma for these 12 patients follows: 4 (33.3%) facial and 8 (66.7%) scalp/neck. Histologic data revealed 24 (61.5%) tumors classified as superficial spreading melanoma with nodular melanoma (12.8%) a distant second. The mean Breslow depth for patients with melanoma-related mortality was 2.4 mm, compared with 1.8 mm for those who were alive at last follow-up.
  
  
  CONCLUSIONS
  Small sample size limited this study.
  
  
  CONCLUSIONS
  This study found that the majority (59%) of H&N melanomas presented as scalp or neck lesions with a predilection for adolescents and boys. Those who experienced melanoma-related mortality had thicker lesions. Superficial spreading melanoma was the most common subtype.
authors.affiliation: Duke University Medical Center, Department of Dermatology, Durham, North Carolina.
authors.forename: Win J
authors.initials: WJ
authors.lastname: Tcheung
authors.affiliation: Duke University Medical Center, Department of Cancer Center Biostatistics, Durham, North Carolina.
authors.forename: Jennifer E
authors.initials: JE
authors.lastname: Marcello
authors.affiliation: Duke University Medical Center, Department of Dermatopathology, Durham, North Carolina.
authors.forename: Puja K
authors.initials: PK
authors.lastname: Puri
authors.affiliation: Duke University Medical Center, Department of Medical Oncology, Durham, North Carolina.
authors.forename: Amy P
authors.initials: AP
authors.lastname: Abernethy
authors.affiliation: Duke University Medical Center, Department of Dermatology, Durham, North Carolina. Electronic address: kelly.nelson@duke.edu.
authors.forename: Kelly C
authors.initials: KC
authors.lastname: Nelson
mesh_terms: D000046:Academic Medical Centers; D000293:Adolescent; D017677:Age Distribution; D002648:Child; D015331:Cohort Studies; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D005260:Female; D006258:Head and Neck Neoplasms / Q000453:epidemiology* / Q000473:pathology / Q000628:therapy; D006801:Humans; D015994:Incidence; D008297:Male; D008545:Melanoma / Q000453:epidemiology* / Q000473:pathology* / Q000628:therapy; D009361:Neoplasm Invasiveness / Q000473:pathology; D009367:Neoplasm Staging; D009657:North Carolina / Q000453:epidemiology; D011379:Prognosis; D012042:Registries; D012189:Retrospective Studies; D018570:Risk Assessment; D021701:Sentinel Lymph Node Biopsy / Q000379:methods / Q000706:statistics & numerical data*; D017678:Sex Distribution; D012878:Skin Neoplasms / Q000401:mortality* / Q000473:pathology* / Q000628:therapy; D016019:Survival Analysis