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Spitzoid melanoma and micrometastases in two lymph node regions: a critical situation


Navarini, A A; Bauer, J; Barysch, M J; Kempf, W; Mihic-Probst, D; Kerl, K; Kamarashev, J; Giovanoli, P; Kolios, A G A; Bergstraesser, E; Dummer, R (2011). Spitzoid melanoma and micrometastases in two lymph node regions: a critical situation. European Journal of Dermatology, 21(2):229-233.

Abstract

Atypical Spitz tumors can hardly be differentiated from spitzoid melanoma. CGH might help in the differential diagnosis. An 8 year old child with an atypical Spitz tumor (with a CGH pattern compatible with melanoma) of 8.0 mm Breslow thickness and micrometastases in two lymph node regions was seen at our department. The management and prognosis of atypical Spitz tumors is controversial, and aggressive procedural steps similar to melanoma are usually not recommended. Even performing sentinel lymph node biopsy has been questioned. After extensive interdisciplinary consultations, we did not recommend resection of both lymph node regions and chose instead to follow-up with regular whole-body MRI and adjuvant treatment with pegylated interferon. Treatment decisions for atypical Spitz tumors are a major medical and ethical challenge due to the limited available data.

Atypical Spitz tumors can hardly be differentiated from spitzoid melanoma. CGH might help in the differential diagnosis. An 8 year old child with an atypical Spitz tumor (with a CGH pattern compatible with melanoma) of 8.0 mm Breslow thickness and micrometastases in two lymph node regions was seen at our department. The management and prognosis of atypical Spitz tumors is controversial, and aggressive procedural steps similar to melanoma are usually not recommended. Even performing sentinel lymph node biopsy has been questioned. After extensive interdisciplinary consultations, we did not recommend resection of both lymph node regions and chose instead to follow-up with regular whole-body MRI and adjuvant treatment with pegylated interferon. Treatment decisions for atypical Spitz tumors are a major medical and ethical challenge due to the limited available data.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Institute of Surgical Pathology
04 Faculty of Medicine > University Hospital Zurich > Dermatology Clinic
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:2011
Deposited On:02 Aug 2011 07:48
Last Modified:05 Apr 2016 14:57
Publisher:John Libbey Eurotext
ISSN:1167-1122
Additional Information:The definitive version is available at: www.jle.com
Publisher DOI:10.1684/ejd.2010.1238
PubMed ID:21489908
Permanent URL: http://doi.org/10.5167/uzh-48845

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