Spitzoid melanocytic lesions describe a spectrum of pediatric melanocytic proliferations ranging from benign Spitz nevi to malignant spitzoid melanomas typically arising within the first two decades of life. Atypical spitzoid neoplasm (ASN) is a poorly defined category within this spectrum that poses a unique diagnostic challenge due to histologic findings with insufficient atypical characteristics to make the diagnosis of melanoma. This report presents an exceptionally rare case of an ulcerative atypical spitzoid neoplasm mimicking an infantile hemangioma in a two-month-old girl treated with pulse dyed laser (PDL) and surgical excision. Our patient ultimately underwent five excisions over a 2-year period, with successful maintenance of function and dexterity of the affected fingers.
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Role of Targeted Sequencing in Routine Diagnostics of Spitz Melanocytic Neoplasms-An Analysis of 70 Cases.
J Cutan Pathol
February 2025
Institute of Pathology, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia.
Article Synopsis
- The Spitz group of melanocytic tumors should ideally include those with specific genomic changes like kinase receptor fusions and HRAS mutations, while traditional melanoma markers like BRAF mutations indicate a different diagnosis.
- A study involving 70 melanocytic tumors utilized targeted sequencing to differentiate between Spitz and conventional melanomas and clarify their classifications.
- The findings revealed substantial discrepancies in initial diagnoses, with 34% of cases having differing outcomes after molecular analysis, highlighting the need for genetic testing to improve diagnostic reliability in challenging cases.
Clinical 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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