Atypical Spitz tumors in patients younger than 18 years.
J Am Acad Dermatol
; 72(1): 37-46, 2015 Jan.
Article
en En
| MEDLINE
| ID: mdl-25446807
ABSTRACT
BACKGROUND:
Diagnosis and proper management of atypical Spitz tumors in pediatric age are still controversial.OBJECTIVE:
We sought to investigate the clinicopathological and molecular features of atypical Spitz tumors in patients aged 18 years or younger.METHODS:
We performed a retrospective clinicopathological and fluorescence in situ hybridization study on 50 pediatric atypical Spitz tumors.RESULTS:
Parameters that were significantly correlated with a diagnosis of atypical Spitz tumors over Spitz nevus included asymmetry, level IV/V, lack of maturation, solid growth, nuclear pleomorphism, high nuclear-cytoplasmic ratio, atypical and deep mitoses, and more than 6 mitoses/mm(2). In the atypical Spitz tumors group, a significantly higher mitotic rate was observed in prepuberal age (P = .04). The 4-probe fluorescence in situ hybridization melanoma assay did not discriminate atypical Spitz tumors from Spitz nevi. Heterozygous 9p21 loss was found in 3 of 37 cases and homozygous 9p21 loss in 2 of 37 cases. Only 1 child experienced a fatal outcome, showing genetic abnormalities by melanoma fluorescence in situ hybridization probe and a heterozygous 9p21 deletion.LIMITATIONS:
The limited number of adverse outcomes did not allow the prognostic analysis of single morphologic features.CONCLUSION:
Pediatric atypical Spitz tumors are associated with minimal lethal potential. Atypical Spitz tumors require complete excision and careful follow-up while our data do not support any clinical benefit for the sentinel lymph node biopsy procedure and completion lymphadenectomy.Palabras clave
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Neoplasias Cutáneas
/
Nevo de Células Epitelioides y Fusiformes
Tipo de estudio:
Observational_studies
/
Risk_factors_studies
Límite:
Adolescent
/
Child
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Child, preschool
/
Female
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Humans
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Infant
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Male
Idioma:
En
Revista:
J Am Acad Dermatol
Año:
2015
Tipo del documento:
Article