Family history, radiation therapy associated with pediatric melanoma

Key takeaways:

• Adolescents with a family history were more likely to be diagnosed with melanoma than controls (P < .046).
• They were also more likely to have received radiation therapy (P < .03).

Patients diagnosed with melanoma as an adolescent or child were more likely to have a family history of melanoma or have undergone radiation therapy, according to a study.

“Given the rarity of pediatric melanoma and differences in its clinical, histological and lymphatic sampling presentations, it is important to better explore risk factors for the occurrence and negative outcomes of melanoma in these patients,” Elena B. Hawryluk, MD, PhD, dermatologist at Massachusetts General Hospital and Boston Children’s Hospital and associate professor at Harvard Medical School, and colleagues wrote. “This study sought to characterize the clinical features of children and young adults with melanoma and identify factors associated with occurrence of pediatric melanoma.”

The retrospective study included 317 pediatric patients with melanoma (40% male). There were 73% initially diagnosed during adolescence (age 11 to < 20 years) and 27% diagnosed during childhood (age < 11 years).

Results showed that 9% of all patients had a family history of melanoma, and adolescent patients with a family history more likely to be diagnosed with melanoma than the matched cohort without skin cancer (P < .046). Adolescent patients with melanoma were also more likely to have received radiation therapy compared with their healthy counterparts (P < .03).

While a history of blistering sunburns and tanning bed usage was present in 29% and 14% of patients with melanoma, respectively, the associations were not significant.

The most common melanoma subtype was spitzoid tumor represented in 59% of childhood cases and 21% of adolescent cases. Superficial spreading and unclassified melanoma followed as the most common melanoma subtypes in adolescents (33% and 23%) and children (9% and 16%). Further, 11% of melanoma cases stemmed from congenital nevi.

Overall, sentinel lymph node biopsies were performed in 68% of cases and were positive in 46% of those cases. Also, 41% of patients experienced metastatic disease. Of the 7% who died from their disease, 79% were diagnosed as adolescents.

“Pediatric melanoma has diverse clinical presentations, and a better understanding of these cases and their outcomes may allow for improved risk stratification of children and adolescents diagnosed with melanoma,” the authors concluded.