Skin melanocytic tumor

Spitz neoplasms

Atypical Spitz tumor (Spitz melanocytoma)



Topic Completed: 1 March 2013

Minor changes: 1 December 2021

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PubMed Search: Atypical Spitz nevus

See also: Spitz nevus

Christopher S. Hale, M.D.
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Cite this page: Hale CS. Atypical Spitz tumor (Spitz melanocytoma). PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/skintumormelanocyticatypicalspitz.html. Accessed January 23rd, 2022.
Definition / general
  • Junctional or compound lesion not fulfilling the histopathologic criteria of melanoma but with one of the following features:
    • Asymmetry
    • Predominance of single melanocytes over nests in lesions 4 mm or larger
    • Ulceration
    • Large dermal sheets of melanocytes
    • Lack of maturation in dermis
    • Deep dermal mitotic figures
    • Extensive involvement of subcutis
    • Nuclear pleomorphism (Mod Pathol 2006;19:S21)
Terminology
  • Also called Spitz tumor with one or more atypical features
Epidemiology
  • Mostly young patients
Clinical features
  • Regional lymph node involvement in up to 1/3 (Hum Pathol 2006;37:816)
  • Usually large and deep with pushing borders into dermis and subcutis
Case reports
Treatment
Microscopic (histologic) description
  • Junctional or compound lesion not fulfilling the histopathologic criteria of melanoma but with one of the following features:
    • Asymmetry
    • Predominance of single melanocytes over nests in lesions 4 mm or larger
    • Ulceration
    • Large dermal sheets of melanocytes
    • Lack of maturation in dermis
    • Deep dermal mitotic figures
    • Extensive involvement of subcutis
    • Nuclear pleomorphism (Arch Dermatol 2005;141:1381, Cancer 2003;97:499)
Microscopic (histologic) images

AFIP images

Large epithelioid
cells with
amphophilic
cytoplasm



Images hosted on other servers:

Various images

Atypical Spitz tumor

Asymmetry but highly cohesive nests



Buttock tumor:

Multinucleated tumor cells

Sheets of atypical tumor cells with frequent mitotic figures

Somewhat symmetric

Large nests of atypical tumor cells

Positive stains
Molecular / cytogenetics description
Differential diagnosis
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