Case Number : Case 285 Posted By: Guest

Phillip McKee - Overseas consultations (Cave Creek, Arizona, USA) Wrote:

Many thanks to Iskander for looking after the spot diagnoses while I was away. Although it is early, so many folk have posted comments, I will give the answer now. As Richard says so emphatically, this is an intradermal Spitz nevus with just a hint of desmoplasia. Figure 2 shows the lesion at the top and Figure 3 shows it at the bottom. There is clear evidence of maturation. The mitotic figure shown in figure 4 comes from the upper part of the nevus and is of no consequence. I showed it to remnind you all that one may see an occasional mitotic figure in a Spitz nevus. Personally, I do not like and do not use the term atypical Spitz nevus. In my view either a lesion is a Spitz nevus or it is a Spitzoid melanoma. In my experience, it is the generally easy to recognize the latter although one occasionally needs immunohistochemistry in difficult cases- MIB-1 Cyclin-D1, p53 etc. If you are unsure about the lesion always show it to colleagues or if necessary send it for a consultation.

Submitted on 13/07/2011 11:23
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Richard Carr - Warwick (UK) Wrote:

Classical (intradermal) Spitz naevus

Submitted on 13/07/2011 10:27
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Pablo Ortega - Hospital Isidro Ayora -Dermatopathology Department (Loja-Ecuador) Wrote:

I think this melanocitic lesion correspond to intradermal spitz nevus.

Submitted on 13/07/2011 10:19
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Eman El-Nabarawy - Cairo University (Egypt) Wrote:

Although the age of the patient highly favours the diagnosis of Spitz nevus, yet I will favour atypical Spitz tumor (Spitzoid melanoma) cause I cant perceive the regular nesting throughout the lesion, more than 2 mitoses (?atypical), pleomorphism of cells at the same level, ??perineural invasion.

Submitted on 13/07/2011 09:34
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Hazem Hamed - Department of Histopathology, Imperial College London. (LONDON) Wrote:

Intradermal Spitz nevus, probably with atypia.

Submitted on 13/07/2011 07:49
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Rodrigo Restrepo - UPB/CES (Mdlln/Col) Wrote:

Sorry.......Atypical Spitz tumor / Spitzoid melanoma

Submitted on 13/07/2011 07:48
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Rodrigo Restrepo - UPB/CES (Medlln/Col) Wrote:

Ayuno al Spitz tumor / Spitzoid melanoma

Submitted on 13/07/2011 07:45
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Diana Alvarez - (The Netherlands) Wrote:

Intradermal Spitz nevus

Submitted on 13/07/2011 07:40
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Marcela Saeb Lima - Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán (Mexico City) Wrote:

Spitz Nevus

Submitted on 13/07/2011 07:23
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Marwa Fawzi - Dermatology Department, Faculty of Medicine, Cairo University (Egypt) Wrote:

Intradermal spitz neavus

Submitted on 13/07/2011 04:46
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ANDREW DANCKWERTS - WITS UNIVERSITY, NHLS (JOHANNESBURG, RSA) Wrote:

SPITZ NEAVUS.

Submitted on 13/07/2011 04:38
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Mona Abdel Halim - Dermatology Department, Faculty of medicine, Cairo University (Egypt) Wrote:

Intradermal Spitz nevus

Submitted on 13/07/2011 04:37
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