Aytül TEMUROĞLU, Gökalp Rüstem AKSOY, Mehtap ERTEKİN, Metin DEMİRKAYA, Betül Berrin SEVİNİR
The Injector - 2025;4(3):99-105
Objective: To examine the clinical characteristics of patients diagnosed with melanocytic neoplasms in childhood. Methods: The study included patients diagnosed with malignant melanoma and Spitzoid melanocytic tumors who were followed up and treated in our clinic between 2000 and 2024. The patients' data were analyzed retrospectively. Results: Of the 36 patients included in the study, 52.8% were female and 47.2% were male. The mean age of the patients was 115.69+/-47.4 months (range, 24-193). According to the localization of lesions, the most frequent site was the extremities, with 58.3% (n = 21). Pathology results revealed that 38.9% of the patients (n=14) were diagnosed with Spitz nevus, 36.1% (n=13) with malignant melanoma, 19.4% (n=7) with Spitz melanocytoma, and 5.6% (n=2) with Spitzoid melanoma. According to our findings, malignant cases were observed in older age groups (p = 0.017) In 66.7% (n=10) of the patients diagnosed with malignant or Spitzoid melanoma, surgical treatment alone was sufficient. Five patients received adjuvant chemotherapy, BRAF inhibitors (dabrafenib, trametinib, and vemurafenib), and immune checkpoint inhibitors (nivolumab). Histopathological examination showed Clark levels ranging from 4 to 5 and Breslow thickness between 5 and 12 mm. Two patients developed relapse, and one patient had refractory disease. Relapse sites were the kidney and liver. The refractory case was a patient diagnosed with a lesion in the anal region with positive surgical margins. Molecular analysis revealed BRAF V600E positivity in three patients and negativity in 2 patients. The mean follow-up period was 77.25+/-48.11 (3-168) months. Two of the 15 patients diagnosed with malignant tumors died. The mean survival rate was 86.7%. Conclusion: Skin tumors in childhood remain rare and challenging cases. Advances in molecular studies may contribute to the diagnostic process.
