Spitz nevus

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Spitz nevus
Spitz nevus.jpg
Spitz nevus
Specialty Oncology, Dermatology
Prognosis benign

A Spitz nevus is a benign skin lesion. A type of melanocytic nevus, it affects the epidermis and dermis. [1]

Contents

It is also known as an epithelioid and spindle-cell nevus, [2] and misleadingly as a benign juvenile melanoma, [2] :691 and Spitz's juvenile melanoma [3] ). The name juvenile melanoma is generally no longer used as it is neither a melanoma, nor does it occur only in children. [4]

Pathophysiology

Micrograph of a Spitz nevus showing the characteristic vertically arranged nests of cells ("hanging bananas"). H&E stain. Spitz nevus - intermed mag.jpg
Micrograph of a Spitz nevus showing the characteristic vertically arranged nests of cells ("hanging bananas"). H&E stain.

The cause of Spitz nevi is not yet known. There is an association with sunburn, but causation is not established. [1] Genetic studies of Spitz nevi have shown that most cells have the normal number of chromosomes, however a minority (25%) of cells have been shown to contain extra copies of parts of some chromosomes, such as the short arm of chromosome 11 (11p). [1]

Diagnosis

Various differential diagnoses of pigmented skin lesions, by relative incidence and malignancy potential, including "Spitz, Reed or spindle nevus" at top right. Pie chart of incidence and malignancy of pigmented skin lesions.png
Various differential diagnoses of pigmented skin lesions, by relative incidence and malignancy potential, including "Spitz, Reed or spindle nevus" at top right.

On histopathology, Spitz nevi characteristically have vertically arranged nests of nevus cells that have both a spindled and an epithelioid morphology. Apoptotic cells may be seen at the dermoepidermal junction. The main histologic differential diagnoses are pigmented spindle cell nevus and malignant melanoma.

Treatment

Surgical removal is usually performed, even though it is benign.[ citation needed ]

Epidemiology

Spitz nevi are uncommon. Their annual incidence was estimated in a coastal population of sub-tropical Queensland to be 1.4 cases per 100,000 people. For comparison, the annual incidence of melanoma in the same population, which is high by world standards [5] is 25.4 cases per 100,000 people. [4]

Although they are most commonly found on people in their first two decades of life, [1] the age range for people with Spitz nevi is from 6 months to 71 years, with a mean age of 22 years and a median age of 19 years. [4]

Eponym

The lesion is named after Sophie Spitz, the pathologist who originally described it in 1948. [6]

See also

Related Research Articles

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A melanocytic nevus is usually a noncancerous condition of pigment-producing skin cells. It is a type of melanocytic tumor that contains nevus cells. Some sources equate the term mole with "melanocytic nevus", but there are also sources that equate the term mole with any nevus form.

<span class="mw-page-title-main">Melanoma</span> Cancer originating in melanocytes

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<span class="mw-page-title-main">Nevus</span> Mole or birthmark; visible, circumscribed, chronic skin lesion

Nevus is a nonspecific medical term for a visible, circumscribed, chronic lesion of the skin or mucosa. The term originates from nævus, which is Latin for "birthmark"; however, a nevus can be either congenital or acquired. Common terms, including mole, birthmark, and beauty mark, are used to describe nevi, but these terms do not distinguish specific types of nevi from one another.

<span class="mw-page-title-main">Seborrheic keratosis</span> Skin disease

A seborrheic keratosis is a non-cancerous (benign) skin tumour that originates from cells, namely keratinocytes, in the outer layer of the skin called the epidermis. Like liver spots, seborrheic keratoses are seen more often as people age.

<span class="mw-page-title-main">Dysplastic nevus</span> Medical condition

A dysplastic nevus or atypical mole is a nevus (mole) whose appearance is different from that of common moles. In 1992, the NIH recommended that the term "dysplastic nevus" be avoided in favor of the term "atypical mole". An atypical mole may also be referred to as an atypical melanocytic nevus, atypical nevus, B-K mole, Clark's nevus, dysplastic melanocytic nevus, or nevus with architectural disorder.

<span class="mw-page-title-main">Dysplastic nevus syndrome</span> Medical condition

Dysplastic nevus syndrome, also known as familial atypical multiple mole–melanoma (FAMMM) syndrome, is an inherited cutaneous condition described in certain families, and characterized by unusual nevi and multiple inherited melanomas. First described in 1820, the condition is inherited in an autosomal dominant pattern, and caused by mutations in the CDKN2A gene. In addition to melanoma, individuals with the condition are at increased risk for pancreatic cancer.

<span class="mw-page-title-main">Lentigo maligna</span> Medical condition

Lentigo maligna is where melanocyte cells have become malignant and grow continuously along the stratum basale of the skin, but have not invaded below the epidermis. Lentigo maligna is not the same as lentigo maligna melanoma, as detailed below. It typically progresses very slowly and can remain in a non-invasive form for years.

<span class="mw-page-title-main">Congenital melanocytic nevus</span> Congenital mole caused by genetic mutations

The congenital melanocytic nevus is a type of melanocytic nevus found in infants at birth. This type of birthmark occurs in an estimated 1% of infants worldwide; it is located in the area of the head and neck 15% of the time.

<span class="mw-page-title-main">Becker's nevus</span> Medical condition

Becker's nevus is a benign skin disorder predominantly affecting males. The nevus can be present at birth, but more often shows up around puberty. It generally first appears as an irregular pigmentation on the torso or upper arm, and gradually enlarges irregularly, becoming thickened and often hairy (hypertrichosis). The nevus is due to an overgrowth of the epidermis, pigment cells (melanocytes), and hair follicles. This form of nevus was first documented in 1948 by American dermatologist Samuel William Becker (1894–1964).

<span class="mw-page-title-main">Blue nevus</span> Type of melanocytic tumor

A blue nevus is a type of coloured mole, typically a single well-defined blue-black bump.

<span class="mw-page-title-main">Halo nevus</span> Medical condition

Halo nevus is a mole that is surrounded by a depigmented ring or 'halo'.

<span class="mw-page-title-main">Sophie Spitz</span> American pathologist

Sophie Spitz was an American pathologist who published the first case series of "juvenile melanoma,", skin lesions that have come to be known as Spitz nevi. For her contributions to pathology, and especially for her foresight in advocating the use of the pap smear when it was newly devised, she is recognized as a prominent pathologist of her time.

<span class="mw-page-title-main">Benign melanocytic nevus</span> Medical condition

A benign melanocytic nevus is a cutaneous condition characterised by well-circumscribed, pigmented, round or ovoid lesions, generally measuring from 2 to 6 mm in diameter. A benign melanocytic nevus may feature hair or pigmentation as well.

<span class="mw-page-title-main">Balloon cell nevus</span> Medical condition

Balloon cell nevus is a benign nevus. It appears like a melanocytic nevus.

Oral pigmentation is asymptomatic and does not usually cause any alteration to the texture or thickness of the affected area. The colour can be uniform or speckled and can appear solitary or as multiple lesions. Depending on the site, depth, and quantity of pigment, the appearance can vary considerably.

<span class="mw-page-title-main">Acral nevus</span> Medical condition

An acral nevus is a cutaneous condition of the palms, soles, fingers, or toes, characterized by a skin lesion that is usually macular or only slightly elevated, and may display a uniform brown or dark brown color, often with linear striations.

<span class="mw-page-title-main">Nevoid melanoma</span> Type of skin cancer

A nevoid melanoma is a malignant neoplastic lesion of the skin. It is a type of melanoma, the most dangerous form of skin cancer. Nevoid melanomas are clinically significant because they are difficult to distinguish from a benign nevus of the skin, which requires no treatment and is common on most individuals. Nevoid morphologies represent up to 3% of all cases of melanoma.

Animal-type melanoma is a rare subtype of melanoma that is characterized by heavily pigmented dermal epithelioid and spindled melanocytes. Animal-type melanoma is also known to be called equine-type melanoma, pigment synthesizing melanoma, and pigmented epithelioid melanocytoma (PEM). While melanoma is known as the most aggressive skin cancer, the mortality for PEM is lower than in other melanoma types. Animal-type melanoma earned its name due to the resemblance of melanocytic tumors in grey horses.

<span class="mw-page-title-main">Choroidal nevus</span> Medical condition

Choroidal nevus is a type of eye neoplasm that is classified under choroidal tumors as a type of benign (non-cancerous) melanocytic tumor. A choroidal nevus can be described as an unambiguous pigmented blue or green-gray choroidal lesion, found at the front of the eye, around the iris, or the rear end of the eye.

References

  1. 1 2 3 4 LeBoit, PE, Burg G, Weedon D, Sarasin A. (Eds) World Health Organization Classification of Tumours: Pathology and Genetics of Skin Tumours. Lyon: IARCPress. 2006.
  2. 1 2 James, William D.; Berger, Timothy G.; et al. (2006). Andrews' Diseases of the Skin: clinical Dermatology. Saunders Elsevier. ISBN   0-7216-2921-0.
  3. Rapini, Ronald P.; Bolognia, Jean L.; Jorizzo, Joseph L. (2007). Dermatology: 2-Volume Set. St. Louis: Mosby. pp. 1728–30. ISBN   978-1-4160-2999-1.
  4. 1 2 3 Crotty, K. Spitz Naevus: Histological features and distinction from malignant melanoma. Australasian Journal of Dermatology. 38 (suppl): S49-S53. 1997.
  5. Ries LAG, et al., eds. SEER Cancer Statistics Review, 1975–2000. Bethesda, MD: National Cancer Institute; 2003: Tables XVI-1-9.
  6. Spitz S. Melanomas of childhood. Am. J. Pathol.1948;24:591-609.