title: Sentinel node biopsy in atypical melanocytic neoplasms in childhood: a single institution experience in 24 patients.
abstract: BACKGROUND
  Sentinel lymph node biopsy (SLNB) is a controversial but frequently used adjunct to wide excision of difficult-to-diagnose melanocytic proliferations of childhood. We herein report our institutional experience with SLNB in pediatric patients with these lesions, hereafter referred to as 'atypical melanocytic proliferations'.
  
  
  METHODS
  Our prospectively collected melanoma database was queried for patients ≤21 years of age status post-SLNB for a diagnosis of atypical melanocytic proliferation in which the diagnosis of melanoma ≥1 mm in depth was considered in the differential diagnosis by one or more expert dermatopathologists and for which no diagnostic consensus could be reached.
  
  
  RESULTS
  Of 24 patients identified over 17 years, 7 patients (29%) had a positive sentinel lymph node (SLN). Six SLN-positive patients underwent complete lymph node dissection, with one (14%) having additional nodal involvement identified. With a median follow-up of 4.1 years (range < 0.1 to 14.8 years), all patients showed no evidence of disease.
  
  
  CONCLUSIONS
  Despite a significant rate of identification of melanocytes in SLNs of children with atypical melanocytic proliferations, survival appears favorable and controversy surrounding the significance of nodal involvement remains. Further studies with larger numbers of patients and long-term follow-up are needed before the true prognostic value of SLNB in this setting can be determined.
authors.affiliation: Department of Pathology and Cell Biology, College of Medicine, University of South Florida, Tampa, FL 33612, USA.
authors.forename: Omie L
authors.initials: OL
authors.lastname: Mills
authors.forename: Suroosh
authors.initials: S
authors.lastname: Marzban
authors.forename: Jonathan S
authors.initials: JS
authors.lastname: Zager
authors.forename: Vernon K
authors.initials: VK
authors.lastname: Sondak
authors.forename: Jane L
authors.initials: JL
authors.lastname: Messina
mesh_terms: D000293:Adolescent; D000328:Adult; D049109:Cell Proliferation; D002648:Child; D002675:Child, Preschool; D003937:Diagnosis, Differential; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008544:Melanocytes / Q000378:metabolism; D008545:Melanoma / Q000378:metabolism / Q000473:pathology*; D018332:Nevus, Epithelioid and Spindle Cell / Q000378:metabolism / Q000473:pathology; D011446:Prospective Studies; D012189:Retrospective Studies; D021701:Sentinel Lymph Node Biopsy