Paediatric melanomas: Western Australian melanoma advisory service experience

Introduction: Paediatric melanoma is a rare condition with poorly defined risk factors. We describe features of childhood melanoma in Western Australia over the last two decades using data from the Western Australian Cancer Registry (WACR) and Western Australian Melanoma Advisory Service (WAMAS).
Method: Retrospective review of paediatric melanoma cases was conducted from prospectively maintained WACR and WAMAS databases. Incident paediatric melanomas between 2000 and 2013 were identified from the cancer registry. Patients referred to WAMAS were reviewed for demographics, clinical information, histology, treatment, recurrence and survival data.
Results: 95 cases of paediatric melanoma were reported to the Cancer Registry since 2000, average of 6 new cases per year. Of these, 25 patients were also referred to WAMAS. Over 72% of patients were between 13-19 years old. The most common site for primary melanoma was the head and neck region (40%). Ten patients (40%) had a pre-existing naevus, 20.0% reported having 1-5 blistering sunburns in the past and 72% had a Fitzpatrick skin grade of 3 or less. Majority of the patients (88%) were diagnosed with a primary invasive lesion at presentation. Superficial spreading melanomas predominated with 32%. All but two patients had localised disease at presentation, with eight patients undergoing further treatment including chemotherapy and neck dissection for metastasis. At the time of review three patients were deceased.
Conclusion: WACR data show that Paediatric melanoma is still a rarity. Certain trends identified in the clinical and histological features of the WAMAS group may suggest risk factors for disease.

Dr. Jie Xu