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Review
. 2025 Jan;486(1):143-164.
doi: 10.1007/s00428-024-03958-7. Epub 2024 Nov 6.

Spitz tumours and mimickers

Arnaud de la Fouchardière  1   2 , María Eugenia Mazzei  3 , María Pastor  3 , Anna-Maria Forster  4 , Victor G Prieto  5
Affiliations
Review

Spitz tumours and mimickers

Arnaud de la Fouchardière et al. Virchows Arch. 2025 Jan.

Abstract

Since their initial description in 1948, Spitz tumours have always been a challenge in the field of dermatopathology and paediatric pathology. Advances in molecular pathology have confirmed they are associated with specific anomalies, mainly gene fusions. They display a wide range of clinical presentations and histological subtypes. Most cases are Spitz nevi and very few lesions match the criteria to be diagnosed as atypical Spitz tumours. Even fewer are labelled as Spitz melanomas. Follow-up studies of genetically characterized cases have repeatedly confirmed that, even if the regional lymph node is involved, the overall outcome remains favourable. The aims of this review are to cover the variety of morphological presentations of Spitz tumours and illustrate the most rare subtypes. When possible, we have pointed out the potential trends between some unusual morphological features and the frequently associated genetic drivers. Spitz tumours have many differential diagnoses, the main being superficial spreading melanoma, with overlapping morphological features in early lesions. Essential clues to discriminate Spitz from mimickers have been listed and illustrated.

Keywords: Atypical Spitz tumours; Spitz melanoma; Spitz nevus; Spitz tumours.

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Conflict of interest statement

Declarations. Conflict of interest: The authors declare no competing interests.

References

    1. Spitz S (1948) Melanomas of childhood. Am J Pathol 24(3):591–609 - PubMed - PMC
    1. Kamino H, Flotte TJ, Misheloff E, Greco MA, Ackerman AB (1979) Eosinophilic globules in Spitz’s nevi. New findings and a diagnostic sign. Am J Dermatopathol 1(4):319–324 - DOI - PubMed
    1. Bastian BC, LeBoit PE, Pinkel D (2000) Mutations and copy number increase of HRAS in Spitz nevi with distinctive histopathological features. Am J Pathol 157(3):967–972. https://doi.org/10.1016/S0002-9440(10)64609-3 - DOI - PubMed - PMC
    1. Yazdan P, Cooper C, Sholl LM et al (2014) Comparative analysis of atypical spitz tumors with heterozygous versus homozygous 9p21 deletions for clinical outcomes, histomorphology, BRAF mutation, and p16 expression. Am J Surg Pathol 38(5):638–645. https://doi.org/10.1097/PAS.0000000000000160 - DOI - PubMed
    1. Massi D, Tomasini C, Senetta R et al (2015) Atypical Spitz tumors in patients younger than 18 years. J Am Acad Dermatol 72(1):37–46. https://doi.org/10.1016/j.jaad.2014.09.049 - DOI - PubMed

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