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Maligne Melanome bei Jugendlichen

  • Conference paper
Onkologische Dermatologie

Part of the book series: Fortschritte der operativen und onkologischen Dermatologie ((OP.DERMATOLOGIE,volume 7))

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Zusammenfassung

Die Diagnose melanozytärer Tumoren bei Jugendlichen ist wegen der großen morphologischen Vielfalt dieser Läsionen oft sehr schwierig. Insbesondere die in dieser Altersgruppe häufig vorkommenden „Pseudomelanome“, wie Spitz-Naevi (und Varianten), dysplastische Naevi, blaue Naevi, u.a., bereiten mitunter Probleme hinsichtlich ihrer differentialdiagnostischen Abgrenzung von Melanomen.

Im Zeitraum von 1970 bis 1990 wurden an der Universitätsklinik für Dermatologie und Venerologie in Graz 14 Patienten im Alter von 14–19 Jahren mit malignen Melanomen (0,9% aller Melanompatienten) beobachtet. Die Geschlechtsverteilung männlich: weiblich betrug 1:6. Bei allen Patienten entwickelte sich das Melanom erst nach der Pubertät. 8 Melanome waren an den Extremitäten, 5 Melanome am Rücken und 1 Melanom im Bereich der behaarten Kopfhaut lokalisiert. Das klinische Bild ergab keine wesentlichen Unterschiede im Vergleich zu den Charakteristika bei Melanomen im Erwachsenenalter. Die histologischen Veränderungen zeigten nicht selten Kriterien des Spitz-Naevus. Während des Nachbeobachtungszeitraumes (Median: 40 Monate, Minimum 1 Monat, Maximum 247 Monate) verstarben 7 von 14 Patienten. Eine 19jährige Patientin mit einer regionären Lymphknotenmetastase ist nach 4 Jahren erscheinungsfrei.

Zusammenfassend kann festgehalten werden: 1. Melanome bei Jugendlichen sind selten. 2. Die histologische Diagnose ist häufig schwierig. 3. Der Verlauf ist durch eine schlechte Prognose gekennzeichnet. 4. Von besonderer Bedeutung ist die Kenntnis der sogenannten „Pseudomelanome“, um die therapeutischen Konsequenzen der Fehldiagnose Melanom zu vermeiden.

Summary

Due to the morphologic variants of melanocytic skin tumors in children and adolescents the diagnosis of these lesions may be difficult. Especially Spitz nevi (and variants), dysplastic nevi, blue nevi, etc., which frequently occur in this age group, often cause problems in differential diagnosis.

Between 1970 and 1990 14 patients under 19 years of age with malignant melanoma (0.9% of all patients with melanoma) were observed at the Department of Dermatology, University of Graz, Austria. The male: female ratio was 1:6. In all patients the melanoma occured after puberty. Eight melanomas were situated on the extremities, five on the trunk and one on the scalp. The clinical characteristics were similar to those observed in melanomas of adults. The histological features often resembled Spitz nevus. During follow-up (median 40 months, range 1–247 months) seven out of 14 patients died. A 19-year-old female patient with regional lymph node metastasis was found to have no further metastases during an observation period of 4 years.

The following conclusions are drawn: (1) Melanomas in childhood and adolescence are rare. (2) Clinical and histopathological diagnosis often is difficult. (3) The clinical course usually is characterized by a bad prognosis. (4) The knowledge of “pseudomelanomas“ is of importance to avoid the therapeutic and psychologic consequences of the diagnosis of malignant melanoma.

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Authors
  1. H. P. Soyer
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  2. E. Rieger
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  3. E. C. Pfaffenthaler
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  4. H. Kerl
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Editor information

Editors and Affiliations

  1. Dermatologische Klinik, Universitätsspital Zürich, Gloriastraße 31, CH-8091, Zürich, Switzerland

    Günter Burg

  2. Klinik u. Poliklinik für Haut- und Geschlechtskrankheiten der Universität Würzburg, Josef-Schneider-Straße 2, W-8700, Würzburg, Bundesrepublik Deutschland

    Albert A. Hartmann

  3. Dermatologische Klinik und Poliklinik, Universität München, Frauenlobstraße 9-11, W-8000, München 2, Bundesrepublik Deutschland

    Birger Konz

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© 1992 Springer-Verlag Berlin Heidelberg

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Soyer, H.P., Rieger, E., Pfaffenthaler, E.C., Kerl, H. (1992). Maligne Melanome bei Jugendlichen. In: Burg, G., Hartmann, A.A., Konz, B. (eds) Onkologische Dermatologie. Fortschritte der operativen und onkologischen Dermatologie, vol 7. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-77690-8_37

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  • DOI: https://doi.org/10.1007/978-3-642-77690-8_37

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-77691-5

  • Online ISBN: 978-3-642-77690-8

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