Spitz Nevus, Spitz Tumor, and Spitzoid Melanoma : A Comprehensive Clinicopathologic Overview - 28/09/13

Doi : 10.1016/j.det.2013.06.012

Gerardo Ferrara, MD ^a,^⁎ , Raffaele Gianotti, MD ^b, Stefano Cavicchini, MD ^c, Tiziana Salviato, MD ^d, Iris Zalaudek, MD ^e,^f, Giuseppe Argenziano, MD ^f
^a Anatomic Pathology Unit, Department of Oncology, ‘Gaetano Rummo’ General Hospital, Via dell’Angelo 1, Benevento I-82100, Italy
^b Department of Pathophysiology and Transplantation, University of Milan, Via Pace 9, Milan I-20122, Italy
^c Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Pace 9, Milan I-20122, Italy
^d Anatomic Pathology Unit, Department of Laboratory Medicine, ‘Santa Maria degli Angeli’ General Hospital, Via Montereale 24, Pordenone I-33170, Italy
^e Department of Dermatology, Medical University of Graz, Auenbruggerplatz 1, Graz A-8036, Austria
^f Dermatology and Skin Cancer Unit, Department of Dermatology, Arcispedale Santa Maria Nuova IRCCS, Viale Risorgimento 80, Reggio Emilia I-42100, Italy

^∗Corresponding author.

Résumé

Spitz nevus can clinically present either in the classical (reddish pink) or the pigmented (brownish black) variant. Dermoscopy demonstrates that the pigmented variant is much more common than the classical variant; however, none of these show dermoscopic patterns clearly distinguishable from melanoma. Even histopathologically, a clear-cut differentiation between benign and malignant spitzoid neoplasms is often difficult, so that intermediate diagnostic categories (atypical Spitz nevus and Spitz tumor) are admitted. Because of these difficulties in clinical and histopathologic evaluation, surgical excision is recommended for clinically atypical spitzoid lesions of childhood and for all spitzoid lesions of adulthood.

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Keywords : Dermoscopy, Histopathology, Spitz nevus, Atypical Spitz nevus, Spitz tumor, Spitzoid melanoma