Case Reports
Patellar Metastatic Melanoma in a 13-Year-Old Boy
Am J Orthop. 2010 December;39(12):582-586
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Thomas F. Burk, BA, Andrew E. Horvai, MD, PhD, Alexander R. Gottschalk, MD, PhD, Stanley P. L. Leong, MD, Mohammed Kashani-Sabet, MD, Robert E. Goldsby, MD, Jason Law, MD, and Richard J. O'Donnell, MD
Mr. Burk is Research Assistant, Department of Orthopaedic Surgery, Dr. Horvai is Associate Clinical Professor, Department of Pathology, Dr. Gottschalk is Associate Professor, Department of Radiation Oncology, Dr. Leong is Professor Emeritus, Department of Surgery, Dr. Goldsby is Associate Professor of Clinical Pediatrics, and Dr. Law is Clinical Fellow, Department of Pediatrics, and Dr. O'Donnell is Professor of Clinical Orthopaedic Surgery and Chief, Orthopaedic Oncology Service, Department of Orthopaedic Surgery, all at University of California, San Francisco, California. Dr. Kashani-Sabet is Associate Professor of Dermatology, California Pacific Medical Center, San Francisco, California.
The incidence of melanoma in US adults is approximately 1.5 per million, with 2% to 5% of patients developing metastatic disease. In children, melanoma is distinctly uncommon, and metastatic disease occurs even more seldom. This case report, the first of a patellar lesion as the initial presentation of metastatic melanoma in a pediatric patient, highlights use of patellectomy and intraoperative radiation therapy in obtaining palliative local control while avoiding periarticular functional morbidity.