Pediatric melanoma of the head and neck: A single institutions experience

Objectives. The objectives of this study were to review our experience with pediatric melanoma of the head and neck and discuss proper diagnostic protocols and suggest a possible treatment algorithm. Study Design: The authors conducted a retrospective chart review of patients under the age of 18 who underwent treatment for melanoma of the head and neck at a tertiary care university hospital. Results. Six patients were identified in the last 25 years at our institution. Four patients had melanomas in the auricle, one in the cheek, and one in the forehead. All occurrences identified presented in the past 7 years. All were treated with wide local excision. Three patients received sentinel lymph node biopsy, one received a neck dissection after identification of positive sentinel nodes, and two patients received postoperative interferon therapy. No surgical complications were reported. At the time of this submission, no patients were found to have recurrence of the disease. Conclusions. Pediatric melanoma of the head and neck may be managed effectively using current techniques used in treating adult patients. The use of sentinel lymph node biopsy is recommended when the depth of invasion cannot be determined from original biopsy, the original pathologic diagnosis is ambiguous, or depth of invasion from biopsy is sufficient to warrant its use. In addition, the use of adjuvant interferon alpha-2b is recommended in patients at high risk for recurrence.