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Spring 2014, Vol. 22 No. 1

Hong Kong J. Dermatol. Venereol. (2014) 22, 30-34


Paediatric Dermatology Column: Case Report

Paediatric melanoma: challenges in diagnosis and management

小兒黑色素瘤:診斷和治療上的挑戰

M Liu, CJA Henderson, M Gupta

Abstract

Paediatric melanoma, although relatively rare, is the most common cutaneous malignant tumour of childhood. It is often not suspected at initial presentation. It may be misdiagnosed due to poor correlation of conventional ABCDE criteria and ambiguous histopathological features. This younger patient group is more likely to have thicker tumours and positive sentinel lymph node biopsy compared with adult melanoma patients at diagnosis. Despite this, melanoma-specific death rates are lower than those in adults. This suggests different biological behaviour of paediatric compared to adult melanomas. Significant psychosocial issues may exist in the patient and their family. These may delay diagnosis and affect the compliance with management and so should be closely monitored, and intervention arranged if warranted.

小兒黑色素瘤雖然較為罕見,但卻是兒童最常見的皮膚惡性腫瘤。在發病初期,常不以為意而被誤診,可能因它與傳統所用的ABCDE標準相關性較差及其含糊的組織病理學特徵所致。這個較年輕的病人群組在確診時,對比起成人黑色素瘤患者,較常有較厚的腫瘤和前哨淋巴結活檢陽性結果。儘管如此,小兒黑色素瘤的特定性死亡率仍較成人為低。這意味著小兒和成人的黑色素瘤存在着生物學行為上的差異。此外,患者和其家人可能會有明顯的心理社交影響,或因此而延誤診斷及影響治療的依從性,故在這方面,實有必要作密切的監測和提供適時的協助。

Keywords: Criteria, diagnosis, management, melanoma, paediatric

關鍵詞: 標準、診斷、治療、黑色素瘤、小兒