Importance: Spitzoid lesions are a group of melanocytic tumors characterized by spindle-like or epithelioid cells with variable malignant potential. While some spitzoid lesions are classified as evidently benign or malignant by clinic and histology, others present with unclear clinical and histological characteristics and are categorized as lesions of intermediate biologic potential. These lesions represent a challenge for pathologists and clinicians alike. No consensus on ancillary diagnostics and clinical management exists. Prediction of their clinical course is difficult. The implementation of ancillary diagnostics is currently subject of extensive discussions.
Observations: We report three cases of spitzoid lesions in three young female patients (3-, 15- and 17 years old) from a single reference center with different clinical and histological manifestations. In each case, uncertain clinical and histological presentation led to the stepwise application of additional diagnostics using immunohistochemistry and a custom next generation sequencing panel optimized for melanocytic lesions (MelArray). Combining ancillary diagnostics helped determine clinical management in all cases by characterizing the biology of these lesions.
Conclusions And Relevance: We illustrate how clinical, histological and molecular features contribute to an optimized management plan in these critical situations and present a possible algorithm for the assessment of spitzoid neoplasms.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7825637 | PMC |
| http://dx.doi.org/10.18632/oncotarget.27854 | DOI Listing |
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Spitz melanoma.
Clin Dermatol
September 2024
Departments of Pathology and Dermatology, UCSF Dermatopathology and Oral Pathology Service, University of California at San Francisco School of Medicine, San Francisco, California, USA. Electronic address:
Article Synopsis
- - The distinction between Spitz nevus and melanoma can be challenging due to their similar histopathologic features, such as large melanocytes with distinct cytoplasm and nuclei.
- - Advances in genomic studies have revealed that Spitz tumors have various genetic origins, leading to different categories of lesions (benign, intermediate, malignant), while some melanomas may resemble Spitz tumors but have typical initiating mutations.
- - The current WHO definition of Spitz tumors focuses on those with mutations in the MAP kinase pathway, aiming to clarify classification and guide treatment, especially for tumors prevalent in younger individuals.*
Spitzoid melanoma of the finger: a case report.
J Med Case Rep
September 2024
Orthopedic Surgery and Traymatology, Habib Bourguiba Hospital, Sfax, Tunisia.
Background: Melanoma is the most malignant skin tumor, with a high metastatic potential. Spitzoid melanoma is a subtype of melanoma requiring rapid management and extensive tumor resection. We have set the goal to recognize anatomical peculiarities and difficulties diagnoses posed by this type of tumor, as well as to recognize the management modalities, especially the surgical one, of malignant spitzoid melanoma.
View Article and Find Full Text PDFClinical features and outcomes of paediatric Spitz-type lesions.
J Plast Reconstr Aesthet Surg
October 2024
Plastic Surgery Unit, Addenbrooke's Hospital, Hills Rd, Cambridge, UK.
Article Synopsis
- Some doctors in the UK are careful about treating Spitz-type lesions in kids, often suggesting they should be removed to be safe.
- Researchers studied 91 kids with these lesions and found that most had harmless forms, and many did not need ongoing check-ups after treatment.
- The study showed that these lesions are usually not harmful, so doctors don't think aggressive treatments are needed for most kids with these skin spots.
[ALK rearranged Spitz melanocytoma: a clinicopathological and molecular genetic analysis of two cases].
Zhonghua Bing Li Xue Za Zhi
August 2024
Department of Pathology, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China.
Article Synopsis
- The study investigates the characteristics of cutaneous ALK-rearranged Spitz melanocytoma through clinical, molecular, and immunohistochemical analysis of two pediatric cases.
- Both cases, involving an 8-year-old boy and an 11-year-old girl, presented with skin lesions and exhibited specific histological features, including medium to large-sized neoplastic cells with distinct cytoplasm and nuclear characteristics.
- The tumors showed strong positivity for certain immunohistochemical markers and confirmed ALK-rearrangement through genetic analysis, indicating a unique subset of Spitz melanocytoma primarily found in children and adolescents, with a favorable prognosis post-resection.
Masquerading Spitz naevi on the upper lip: A case report with a brief review of the literature.
J Oral Maxillofac Pathol
April 2024
Department of Oral Pathology and Microbiology, ESIC Dental College and Hospital, Rohini, Delhi, India.
Article Synopsis
- - The rising occurrence of oral squamous cell carcinoma (OSCC) in younger individuals necessitates careful diagnosis by oral pathologists, as some lesions can mimic malignant tumors.
- - While pediatric malignancies like OSCC are rare in very young children, benign melanocytic lesions such as Spitz naevi are more common and can complicate diagnoses due to their histological similarities with cancer.
- - Employing diagnostic tools like immunohistochemistry (IHC) and focusing on clinical and histopathological correlations is crucial, as illustrated by a case where a lesion initially suspected to be cancerous was found to be a benign melanocytic naevus.
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