ABSTRACT
INTRODUCTION: Sentinel lymph node biopsy (SLNB) is a controversial but frequently used adjunct to wide excision of difficult-to-diagnose melanocytic proliferations of childhood. We herein report our institutional experience with SLNB in pediatric patients with these lesions, hereafter referred to as 'atypical melanocytic proliferations'. METHODS: Our prospectively collected melanoma database was queried for patients ≤21 years of age status post-SLNB for a diagnosis of atypical melanocytic proliferation in which the diagnosis of melanoma ≥1 mm in depth was considered in the differential diagnosis by one or more expert dermatopathologists and for which no diagnostic consensus could be reached. RESULTS: Of 24 patients identified over 17 years, 7 patients (29%) had a positive sentinel lymph node (SLN). Six SLN-positive patients underwent complete lymph node dissection, with one (14%) having additional nodal involvement identified. With a median follow-up of 4.1 years (range < 0.1 to 14.8 years), all patients showed no evidence of disease. CONCLUSIONS: Despite a significant rate of identification of melanocytes in SLNs of children with atypical melanocytic proliferations, survival appears favorable and controversy surrounding the significance of nodal involvement remains. Further studies with larger numbers of patients and long-term follow-up are needed before the true prognostic value of SLNB in this setting can be determined.
Subject(s)
Cell Proliferation , Melanoma/pathology , Sentinel Lymph Node Biopsy , Adolescent , Adult , Child , Child, Preschool , Diagnosis, Differential , Female , Follow-Up Studies , Humans , Lymphatic Metastasis , Male , Melanocytes/metabolism , Melanoma/metabolism , Nevus, Epithelioid and Spindle Cell/metabolism , Nevus, Epithelioid and Spindle Cell/pathology , Prospective Studies , Retrospective StudiesABSTRACT
BACKGROUND: Lipomas are the most common benign neoplasm of the head and neck. However, osteolipomas, a rare variant of lipoma, are uncommon in this location. When they occur, variations in location and radiographic presentation may obscure the diagnosis. METHODS AND RESULTS: A 68-year-old man presented with left jaw pain and numbness in the maxillary (V-1) distribution. A CT angiography of the neck revealed a possible liposarcoma. Embolization of the mass was determined to be unfeasible. Consequently, surgical resection was performed revealing a benign osteolipoma. CONCLUSION: We report a rare case of osteolipoma of the parapharyngeal space. Clinicians should be aware that the clinical and radiological features of patients with head and neck osteolipomas may mimic malignant neoplasms. When given deserved consideration, inappropriate treatment of an otherwise benign lesion may be avoided.
