Case Number : Case 471 Posted By: Guest

[b]Phillip McKee - Overseas Consultations (Cave Creek, Arizona, USA) Wrote:[/b]

I think that there must have been some confusion when the case was sent (by me) to the website. In any event, this is a classical Spitz nevus. It is not a melanoma. I agree that the patient is a bit old for a Spitz nevus but one does encounter such lesions in older folk albeit rarely. The best image is the first one. The lesion begins and ends with a nest and is perfectly symmetrical. The pagetoid spread is minimal and is centered on the middle of the lesion. Sorry for any confusion

[size=2]Submitted on 30/03/2012 18:06[/size]
[b]Richard Carr - Warwick (UK) Wrote:[/b]

Classical Spitz naevus for me based on these images. Great case for discussion etc.

[size=2]Submitted on 30/03/2012 16:37[/size]
[b]Izzat Abdul-kadir - ST2 - York Hospital (UK) Wrote:[/b]

Thank you for your reply, Marcela.

[size=2]Submitted on 30/03/2012 12:20[/size]
[b]Marcela Saeb Lima - INCMNSZ (Mexico City) Wrote:[/b]

Dear Izzat Abdul. I do agree with you, however I am not looking at all slides and all sections, and by clinical criteria this can not be a spitz nevus, or might say, it is less likely to be a Spitz nevus. Microscopically the cells of the dermal component do not seem to show maturation and show pleomorphic cytology. Thank you very much for your observation.

[size=2]Submitted on 29/03/2012 21:34[/size]
[b]Iskander Chaudhry - Central Manchester Trust (Manchester, U.K.) Wrote:[/b]

Dear All, I always get the difficult cases to comment on - I am covering for Phillip today- it is a spitzoid melanoma - I have asked Phillip to comment on the case!

[size=2]Submitted on 29/03/2012 19:31[/size]
[b]Francisco Vílchez Márquez - Department of Dermatology. Clinical Universitary Hospital Virgen de la Victoria (Málaga, Spain) Wrote:[/b]

Melanoma

[size=2]Submitted on 29/03/2012 19:26[/size]
[b]Izzat Abdul-kadir - ST2 - York Hospital (UK) Wrote:[/b]

I beg to differ with Marcela & Graham. A pre-test probability should not alter the test. One can choose to ignore the test (i.e. call it, microscopically, a naevus & treat it, clinically, as a melanoma). What one cannot do it is say it looks like a naevus but call it a melanoma, or call every Spitz naevus after the age of 40 a melanoma.

[size=2]Submitted on 29/03/2012 18:07[/size]
[b]Rodrigo Restrepo - UPB/CES (Mdlln/Col) Wrote:[/b]

Spitz naevus.

[size=2]Submitted on 29/03/2012 16:46[/size]
[b]Marie MD - () Wrote:[/b]

Spitz' nevus

[size=2]Submitted on 29/03/2012 16:41[/size]
[b]Marwa Fawzy - Dermatology Department, Faculty of Medicine, Cairo University (Egypt) Wrote:[/b]

Pigmented Spitz

[size=2]Submitted on 29/03/2012 16:14[/size]
[b]Graham Reilly - PEH (Guernsey) Wrote:[/b]

Spitz naevus.However I agree with Marcela and would consider this a spitzoid melanoma in view of age.

[size=2]Submitted on 29/03/2012 15:41[/size]
[b]Francisco Morales Rodriguez - Hospital General de Puebla. Mexico (Puebla . Pue) Wrote:[/b]

Melanoma

[size=2]Submitted on 29/03/2012 14:43[/size]
[b]Marcela Saeb Lima - INCMNSZ (Mexico City) Wrote:[/b]

I do not feel comfortable calling this lesions pigmented Spitz nevus in a 42 year old woman that has a nodule on the thigh. Just by clinical data the most probable diagnosis is Spitzoid melanoma.

[size=2]Submitted on 29/03/2012 14:39[/size]
[b]Mona Abdel Halim - () Wrote:[/b]

Pigmented spitz nevus

[size=2]Submitted on 29/03/2012 14:28[/size]
[b]Bostjan Luzar - Institute of Pathology, Medical Faculty (Ljubljana, Slovenia) Wrote:[/b]

Although the lesion looks well circumscribed and the epidermis is acanthotic in the central part of the lesion, I do not like the morphology of melanocytes: large nuclei with nucleoli, the cytoplasm is unevely pigmented, and I cannot appreciate maturation in the dermal component. My main consideration is spitzoid melanoma.

[size=2]Submitted on 29/03/2012 14:27[/size]
[b]ANDREW DANCKWERTS - (JHB, RSA) Wrote:[/b]

SPITZ NEVUS.

[size=2]Submitted on 29/03/2012 14:16[/size]
[b]Eman El-Nabarawy - (Egypt) Wrote:[/b]

Pigmented spitz nevus.

[size=2]Submitted on 29/03/2012 14:10[/size]
[b]Sasi Attili - (United Kingdom) Wrote:[/b]

Pigmented Spitz again

[size=2]Submitted on 29/03/2012 12:53[/size]
[b]Izzat Abdul-kadir - ST2 - York Hospital (UK) Wrote:[/b]

Spitz naevus.

[size=2]Submitted on 29/03/2012 11:30[/size]