2002
DOI: 10.1001/archderm.138.5.625
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Reliability of the Histopathologic Diagnosis of Malignant Melanoma in Childhood

Abstract: To assess interrater reliability in the diagnosis of malignant melanoma in children.Design, Setting, and Participants: We collected 85 slides of melanomas diagnosed in patients younger than 17 years through a network of dermatopathologists and dermatologists. The slides were classified into 3 categories: (1) slides from children with metastatic melanoma; (2) slides from disease-free children with a follow-up of less than 5 years; (3) slides from disease-free children with a follow-up of 5 years or longer. Cate… Show more

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Cited by 81 publications
(46 citation statements)
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References 28 publications
(26 reference statements)
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“…24 Of greater concern is the estimate from one group that, among children, more than 40% of cases diagnosed as Spitz nevus are actually a malignancy that has been misdiagnosed. 25 Few studies have been published characterizing the differential expression of any marker between Spitz nevi and spitzoid melanomas with only CD99, a transmembrane protein associated with the epithelial-mesenchymal transformation, showing moderate discriminant activity between the two lesions. 26 Two immunohistochemical studies of HMB45 staining in Spitz nevi have been published, one reporting on 15 cases, the other on 30.…”
Section: Discussionmentioning
confidence: 99%
“…24 Of greater concern is the estimate from one group that, among children, more than 40% of cases diagnosed as Spitz nevus are actually a malignancy that has been misdiagnosed. 25 Few studies have been published characterizing the differential expression of any marker between Spitz nevi and spitzoid melanomas with only CD99, a transmembrane protein associated with the epithelial-mesenchymal transformation, showing moderate discriminant activity between the two lesions. 26 Two immunohistochemical studies of HMB45 staining in Spitz nevi have been published, one reporting on 15 cases, the other on 30.…”
Section: Discussionmentioning
confidence: 99%
“…22 In our hands and in the experience of others, predicting a malignant phenotype in melanocytic proliferations in childhood is particularly challenging. 23 The fourth consideration is that melanoma, as it is a disease of young as well as old patients, has the potential to cause great loss of life with attendant social and economic disruption for the family members of the deceased, as it results in more lost years of life per case fatality than any other neoplastic disorder, except perhaps leukemia. 1,24 Underdiagnosis With respect to the underdiagnosis of melanoma, several factors can increase the risk of such events.…”
Section: The Nature Of Error In Dermatopathological Practicementioning
confidence: 99%
“…Not surprisingly, a recent study of interrater reliability of the diagnosis of malignant melanoma in childhood was poor, even when the slides were evaluated by pairs of experts. 29 Other groups have reported better diagnostic concordance with respect to melanocytic lesions. 30,31 The interobserver concordance reported in the present study is maximized because only 2 diagnostic "bins" were used: positive or negative for LM and/or LMM.…”
Section: Commentmentioning
confidence: 97%