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Slack JC, Church AJ. Molecular Alterations in Pediatric Solid Tumors. Clin Lab Med 2024; 44:277-304. [PMID: 38821645 DOI: 10.1016/j.cll.2023.08.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2024]
Abstract
Pediatric tumors can be divided into hematologic malignancies, central nervous system tumors, and extracranial solid tumors of bone, soft tissue, or other organ systems. Molecular alterations that impact diagnosis, prognosis, treatment, and familial cancer risk have been described in many pediatric solid tumors. In addition to providing a concise summary of clinically relevant molecular alterations in extracranial pediatric solid tumors, this review discusses conventional and next-generation sequencing-based molecular techniques, relevant tumor predisposition syndromes, and the increasing integration of molecular data into the practice of diagnostic pathology for children with solid tumors.
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Affiliation(s)
- Jonathan C Slack
- Pathology & Laboratory Medicine Institute (Robert J. Tomsich), Cleveland Clinic, Cleveland, OH, USA
| | - Alanna J Church
- Department of Pathology, Boston Children's Hospital, Harvard Medical School, 300 Longwood Avenue, Boston, MA 02115, USA.
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Sondak VK, Messina JL. Melanoma in Pediatric and Young Adult Patients. Curr Oncol Rep 2024:10.1007/s11912-024-01542-5. [PMID: 38780675 DOI: 10.1007/s11912-024-01542-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/01/2024] [Indexed: 05/25/2024]
Abstract
PURPOSE OF REVIEW Melanoma in younger individuals has different clinical presentations, histologic characteristics and prognosis from older patients. This review summarizes key differences and important new insights into pediatric and young adult melanoma, as well as recent evolutions in treatment. RECENT FINDINGS Molecular techniques have improved the classification of melanocytic neoplasms, and are especially useful in the workup of the diagnostically challenging lesions frequent in this age group. Molecular evaluation highlights differences between melanoma and atypical lesions with Spitz-like morphology, and should routinely be incorporated for diagnosing and classifying Spitzoid melanocytic to guide prognostication and treatment. Once diagnosed, the management of bona fide melanoma in children and young adults is largely similar to older patients, while the optimal management of lesions such as atypical Spitz tumors remains uncertain. Increased awareness of the presentation and diagnostic characteristics of melanoma in young individuals will allow earlier detection, and improved diagnostic techniques will allow optimum management without over- or under-treatment.
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Affiliation(s)
- Vernon K Sondak
- Department of Cutaneous Oncology, Moffitt Cancer Center, Tampa, FL, U.S.A..
| | - Jane L Messina
- Department of Cutaneous Oncology, Moffitt Cancer Center, Tampa, FL, U.S.A
- Department of Pathology, Moffitt Cancer Center, Tampa, FL, U.S.A
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Uzunçakmak TK, Yücesoy SN, Önenerk AM, Özdil A, Engin B. Comparison of Clinicopathological Findings of Spitz Nevus in Pediatric and Adult Patients. Turk Arch Pediatr 2024; 59:49-53. [PMID: 38454260 PMCID: PMC10837512 DOI: 10.5152/turkarchpediatr.2024.23154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 10/04/2023] [Indexed: 03/09/2024]
Abstract
OBJECTIVE The aim of this study is to evaluate the demographic characteristics of patients diagnosed with Spitz nevus and to investigate potential distinctions in clinicopathological findings of Spitz nevi in relation to age and location of the lesion. MATERIALS AND METHODS Clinical and histopathological findings of 32 patients who were diagnosed with Spitz nevus from our archives between 2010 and 2020 were obtained and evaluated retrospectively. RESULTS A total of 32 patients were included, of whom 19 (59.4%) were female and 15 (40.6%) were under the age of 18 years. Most of the lesions (14, 43.7%) were located on the upper extremity, followed by the lower extremity and the head and neck. The most common histological subtype was the compound variant. In the pediatric age group, the majority of the lesions were located on the upper extremity, and the most common histological subtypes were pigmented and compound variant. In adults, the lesions were chiefly located on the lower extremitiy and the most common histological subtype was the desmoplastic variant. CONCLUSION In this study, it was found that the location of the lesions and histopathological subtypes of Spitz nevi may differ in children and adults. Further studies incorporating genetic data and involving larger cohorts of patients are needed in order to determine these differences between age groups more clearly. The small sample size is the main limitation of this study Cite this article as: Uzunçakmak TK, Yücesoy SN, Önenerk AM, Özdil A, Engin B. Comparison of clinicopathological findings of spitz nevus in pediatric and adult patients. Turk Arch Pediatr. 2024;59(1):49-53.
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Affiliation(s)
| | | | - Ayşe Mine Önenerk
- Department of Pathology, İstanbul University-Cerrahpaşa, Cerrahpaşa Faculty of Medicine, İstanbul, Turkey
| | - Ayşenur Özdil
- Department of Public Health, İstanbul University-Cerrahpaşa, Cerrahpaşa Faculty of Medicine, İstanbul, Turkey
| | - Burhan Engin
- Department of Dermatology, Hassa State Hospital, Hatay, Turkey
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Hatheway Marshall E, Alvarez G, Wang B, Crimmins J, Schneider MM, Selim MA, Al-Rohil RN. Pediatric Atypical Melanocytic Proliferations: Single-Site Retrospective Cohort Assessment of Treatment and Long-Term Follow-Up. Cancers (Basel) 2023; 15:5804. [PMID: 38136349 PMCID: PMC10741983 DOI: 10.3390/cancers15245804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 12/06/2023] [Accepted: 12/09/2023] [Indexed: 12/24/2023] Open
Abstract
Atypical and malignant cutaneous tumors are understudied in the pediatric population, with limited data on long-term follow-up. This study examines pediatric (0-18 years) atypical melanocytic proliferations over a twenty-year period (January 2002-December2022) using the EPIC SlicerDicer at our institution. Over a twenty-year period, there were 55 cases of pediatric melanoma (53 patients). The median follow-up time was 8 years, 11 months. A proportion of 96% were treated with wide local excision (WLE), and 47% had a sentinel lymph node biopsy (SLNB) (35% positive rate). There were 101 atypical Spitz tumor cases (85% atypical Spitz tumors, 15% Spitz melanoma), with a median follow-up duration of 9 years. A proportion of 77% were treated with WLE (with one patient dying of metastatic disease). There were 10 cases of atypical melanocytic proliferations not otherwise specified, including 5 pigmented epithelioid melanocytomas (PEM), 4 deep-penetrating nevi, and 1 atypical cellular blue nevus. This study adds to the growing body of knowledge on pediatric atypical cutaneous melanocytic proliferations, aligning with many described characteristics such as disease location and overall survival rates, with distinct exceptions (higher melanoma positive SLNB rate, lower atypical Spitz tumor WLE rate, and a case of fatal metastatic atypical Spitz tumor).
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Affiliation(s)
| | - Gabriella Alvarez
- Department of Internal Medicine, The University of Texas Health Sciences Center at Houston, Houston, TX 77030, USA;
| | - Bangchen Wang
- Department of Pathology, Duke University Medical Center, Durham, NC 27710, USA; (B.W.); (J.C.); (M.A.S.)
| | - Jennifer Crimmins
- Department of Pathology, Duke University Medical Center, Durham, NC 27710, USA; (B.W.); (J.C.); (M.A.S.)
| | - Michelle M. Schneider
- Department of Pathology, Duke University Medical Center, Durham, NC 27710, USA; (B.W.); (J.C.); (M.A.S.)
| | - M. Angelica Selim
- Department of Pathology, Duke University Medical Center, Durham, NC 27710, USA; (B.W.); (J.C.); (M.A.S.)
| | - Rami N. Al-Rohil
- Department of Pathology, Duke University Medical Center, Durham, NC 27710, USA; (B.W.); (J.C.); (M.A.S.)
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Araiza-Atanacio I, Venegas-Andrade A, Toussaint-Caire S, Palacios-López C. Atypical Presentation of Spitz Nevus: A Case Report. Skin Appendage Disord 2023; 9:461-464. [PMID: 38058542 PMCID: PMC10697764 DOI: 10.1159/000533385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Accepted: 07/28/2023] [Indexed: 12/08/2023] Open
Abstract
Introduction The Spitz nevus (SN) is an acquired melanocytic neoplasm composed of epithelioid and/or spindle cells, which tends to develop in childhood. In pediatric patients, it is usually located on the face and neck. Unusual locations have been found in the literature, such as the penis, mouth, and tongue, as well as 2 cases of ungual SN. Case Report A 15-year-old male evaluated for dark brown-black longitudinal melanonychia that covered 40% of the nail, with pseudo-Hutchinson's sign, of 1 year of evolution. Discussion The SN accounts for 1% of the melanocytic neoplasms. In the present paper, we show the third case of ungual SN never previously disclosed, which presents a zigzag pattern reported in the literature for its association with the pediatric population.
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Affiliation(s)
| | | | - Sonia Toussaint-Caire
- Dermatopathology Department, Hospital General "Dr. Manuel Gea González," Mexico City, Mexico
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Viglizzo G, Herzum A, Gariazzo L, Garibeh E, Occella C. Pediatric spitzoid lesions of the ear: a single-center experience and review of the literature. Dermatol Reports 2023; 15:9642. [PMID: 37753232 PMCID: PMC10518529 DOI: 10.4081/dr.2023.9642] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Accepted: 04/03/2023] [Indexed: 09/28/2023] Open
Abstract
Spitzoid lesions are challenging melanocytic lesions comprising benign, intermediate, and malignant lesions. In this study, we aimed to analyze the diagnostic accuracy of clinical and dermatoscopical evaluations of pediatric spitzoid ear lesions. We collected and analyzed, clinically, dermatoscopically, and histologically, pediatric spitzoid ear lesions. We also conducted a systematic review of the literature. At the Pediatric Hospital Gaslini, excision and histopathological evaluation were performed on eight cases: 87.5% of the lesions were consistent with Spitz nevus (SN), and 12.5% with atypical Spitz tumor (AST). Notably, multiple (≥2) dermatoscopical irregularities were present in 5 of 7 SN (71%), yet none were found in AST (0%, 0/1) (Fisher's exact test, P=0.375). From systematic research in the literature, 9 patients were included in this review. At histology, 88.9% were SN and 11% AST. Remarkably, also in the literature, multiple dermatoscopical irregularities were present in most SN (75%, 6/8), but not in the identified AST (0%, 0/1) (P=0.3333). We present a monocentric study on pediatric spitzoid ear lesions. Importantly, dermatoscopical irregularities were not significantly associated with AST, neither in our series nor in the reviewed literature (respectively P=0.375 and P=0.3333), supporting the fact that relying only on the dermatoscopical aspect of spitzoid lesions is not accurate enough for the special site of the ear, where dermatoscopy could actually be misleading.
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Affiliation(s)
| | - Astrid Herzum
- Dermatology Unit, Pediatric Hospital IRCSS Giannina Gaslini, Genoa, Italy
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Herzum A, Occella C, Vellone VG, Gariazzo L, Pastorino C, Ferro J, Sementa A, Mazzocco K, Vercellino N, Viglizzo G. Paediatric Spitzoid Neoplasms: 10-Year Retrospective Study Characterizing Histological, Clinical, Dermoscopic Presentation and FISH Test Results. Diagnostics (Basel) 2023; 13:2380. [PMID: 37510125 PMCID: PMC10378405 DOI: 10.3390/diagnostics13142380] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 07/13/2023] [Accepted: 07/13/2023] [Indexed: 07/30/2023] Open
Abstract
INTRODUCTION Spitzoid lesions are a wide tumour class comprising Spitz nevus (SN), atypical Spitz tumour (AST) and Spitz melanoma (SM). MATERIALS AND METHODS We conducted a single-centre-based retrospective survey on all histologically diagnosed spitzoid lesions of paediatric patients (1-18 years) of the last 10 years (2012-2022). Histopathological reports and electronic records of patients were used to retrieve relevant data regarding patients' features, clinical and dermatoscopical aspects of lesions when recorded, and FISH tests when present. RESULTS Of 255 lesions, 82% were histologically benign, 17% atypical, 1% malignant. Clinically, 100% of SM were large (≥6 mm) and raised; AST were mainly large (63%), raised (98%), pink (95%). Small (≤5 mm), pigmented, flat lesions correlated with benign histology (respectively 90%, 97%, 98% SN) (p < 0.0001). Dermatoscopical patterns were analysed in 100 patients: starburst pattern correlated with benign histology (26% SN (p = 0.004)), while multicomponent pattern correlated with atypical/malignant lesions (56% AST, 50% SM (p = 0.0052)). Eighty-five lesions were subjected to fluorescence in situ hybridization (FISH): 34 (71% AST; 29% SN) were FISH-positive; 51 (63% SN; 37% AST) were FISH-negative (p = 0.0038). DISCUSSION This study confirmed predominant benign histology (82%) of paediatric spitzoid lesions, thus detecting 17% AST and 1% SM, highlighting the need for caution in handling spitzoid lesions. CONCLUSION Until AST are considered potentially malignant proliferations and no reliable criteria are identified to distinguish them, the authors suggest a prudent approach, especially in children.
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Affiliation(s)
- Astrid Herzum
- Dermatology Unit, U.O.C. Dermatologia e Centro Angiomi, IRCCS Istituto Giannina Gaslini, Via Gerolamo Gaslini, 5-16147 Genova, Italy
| | - Corrado Occella
- Dermatology Unit, U.O.C. Dermatologia e Centro Angiomi, IRCCS Istituto Giannina Gaslini, Via Gerolamo Gaslini, 5-16147 Genova, Italy
| | - Valerio Gaetano Vellone
- Pathology Unit, U.O.C. Anatomia Patologica, IRCCS Istituto Giannina Gaslini, Via Gerolamo Gaslini, 5-16147 Genova, Italy
| | - Lodovica Gariazzo
- Dermatology Unit, U.O.C. Dermatologia e Centro Angiomi, IRCCS Istituto Giannina Gaslini, Via Gerolamo Gaslini, 5-16147 Genova, Italy
| | - Carlotta Pastorino
- Dermatology Unit, U.O.C. Dermatologia e Centro Angiomi, IRCCS Istituto Giannina Gaslini, Via Gerolamo Gaslini, 5-16147 Genova, Italy
| | - Jacopo Ferro
- Dermatology Unit, U.O.C. Dermatologia e Centro Angiomi, IRCCS Istituto Giannina Gaslini, Via Gerolamo Gaslini, 5-16147 Genova, Italy
| | - Angela Sementa
- Pathology Unit, U.O.C. Anatomia Patologica, IRCCS Istituto Giannina Gaslini, Via Gerolamo Gaslini, 5-16147 Genova, Italy
| | - Katia Mazzocco
- Pathology Unit, U.O.C. Anatomia Patologica, IRCCS Istituto Giannina Gaslini, Via Gerolamo Gaslini, 5-16147 Genova, Italy
| | - Nadia Vercellino
- Dermatology Unit, U.O.C. Dermatologia e Centro Angiomi, IRCCS Istituto Giannina Gaslini, Via Gerolamo Gaslini, 5-16147 Genova, Italy
| | - Gianmaria Viglizzo
- Dermatology Unit, U.O.C. Dermatologia e Centro Angiomi, IRCCS Istituto Giannina Gaslini, Via Gerolamo Gaslini, 5-16147 Genova, Italy
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8
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El Sharouni MA, Rawson RV, Potter AJ, Paver EC, Wilmott JS, Witkamp AJ, Sigurdsson V, van Diest PJ, Scolyer RA, Thompson JF, Lo SN, van Gils CH. Melanomas in children and adolescents: Clinicopathologic features and survival outcomes. J Am Acad Dermatol 2023; 88:609-616. [PMID: 36509217 DOI: 10.1016/j.jaad.2022.08.067] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 08/22/2022] [Accepted: 08/25/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND Melanomas in the first 2 decades of life are uncommon and poorly understood. OBJECTIVE To assess clinicopathologic features and survival of children (≤11 years) and adolescents (12-19 years) diagnosed with melanoma. METHODS A pooled cohort of 514 patients was analyzed (397 Dutch, 117 Australian; 62 children, 452 adolescents). Pathology reports were reevaluated to determine melanoma subtypes. Multivariable Cox models were generated for recurrence-free survival (RFS) and overall survival (OS). RESULTS Melanoma subtypes were conventional melanoma (superficial spreading, nodular, desmoplastic, and acral lentiginous), spitzoid melanoma, and melanoma associated with a congenital nevus in 428, 78, and 8 patients, respectively. Ten-year RFS was 91.5% (95% confidence interval [CI], 82.4%-100%) in children and 86.4% (95% CI, 82.7%-90.3%) in adolescents (P = .32). Ten-year OS was 100% in children and 92.7% (95% CI, 89.8%-95.8%) in adolescents (P = .09). On multivariable analysis possible only for the adolescent cohort due to the small number of children, ulceration status, and anatomic site were associated with RFS and OS, whereas age, sex, mitotic index, sentinel node status and melanoma subtype were not. Breslow thickness >4 mm was associated with worse RFS. LIMITATIONS Retrospective study. CONCLUSIONS Survival rates for children and adolescents with melanomas were high. Ulceration, head or neck location and Breslow thickness >4 mm predicted worse survival in adolescents.
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Affiliation(s)
- Mary-Ann El Sharouni
- Melanoma Institute Australia, The University of Sydney, Sydney, NSW, Australia; Department of Dermatology, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
| | - Robert V Rawson
- Melanoma Institute Australia, The University of Sydney, Sydney, NSW, Australia; Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia; Department of Tissue Oncology and Diagnostic Pathology, Royal Prince Alfred Hospital and NSW Health Pathology, Sydney, NSW, Australia
| | - Alison J Potter
- Melanoma Institute Australia, The University of Sydney, Sydney, NSW, Australia; Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia; Department of Tissue Oncology and Diagnostic Pathology, Royal Prince Alfred Hospital and NSW Health Pathology, Sydney, NSW, Australia
| | - Elizabeth C Paver
- Melanoma Institute Australia, The University of Sydney, Sydney, NSW, Australia; Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia; Department of Tissue Oncology and Diagnostic Pathology, Royal Prince Alfred Hospital and NSW Health Pathology, Sydney, NSW, Australia
| | - James S Wilmott
- Melanoma Institute Australia, The University of Sydney, Sydney, NSW, Australia; Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia; Charles Perkins Centre, The University of Sydney, Sydney, NSW, Australia
| | - Arjen J Witkamp
- Department of Surgery, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
| | - Vigfús Sigurdsson
- Department of Dermatology, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
| | - Paul J van Diest
- Department of Pathology, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
| | - Richard A Scolyer
- Melanoma Institute Australia, The University of Sydney, Sydney, NSW, Australia; Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia; Department of Tissue Oncology and Diagnostic Pathology, Royal Prince Alfred Hospital and NSW Health Pathology, Sydney, NSW, Australia; Charles Perkins Centre, The University of Sydney, Sydney, NSW, Australia
| | - John F Thompson
- Melanoma Institute Australia, The University of Sydney, Sydney, NSW, Australia; Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia; Department of Melanoma and Surgical Oncology, Royal Prince Alfred Hospital, Camperdown, NSW, Australia.
| | - Serigne N Lo
- Melanoma Institute Australia, The University of Sydney, Sydney, NSW, Australia; Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Carla H van Gils
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, University Utrecht, Utrecht, the Netherlands
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Mito JK, Weber MC, Corbin A, Murphy GF, Zon LI. Modeling Spitz melanoma in zebrafish using sequential mutagenesis. Dis Model Mech 2022; 15:276442. [PMID: 36017742 PMCID: PMC9438928 DOI: 10.1242/dmm.049452] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Accepted: 07/13/2022] [Indexed: 01/13/2023] Open
Abstract
Spitz neoplasms are a diverse group of molecularly and histologically defined melanocytic tumors with varying biologic potentials. The precise classification of Spitz neoplasms can be challenging. Recent studies have revealed recurrent fusions involving multiple kinases in a large proportion of Spitz tumors. In this study, we generated a transgenic zebrafish model of Spitz melanoma using a previously identified ZCCHC8-ROS1 fusion gene. Animals developed grossly apparent melanocytic proliferations as early as 3 weeks of age and overt melanoma as early as 5 weeks. By 7 weeks, ZCCHC8-ROS1 induced a histologic spectrum of neoplasms ranging from hyperpigmented patches to melanoma. Given the swift onset of these tumors during development, we extended this approach into adult fish using a recently described electroporation technique. Tissue-specific expression of ZCCHC8-ROS1 in adults led to melanocyte expansion without overt progression to melanoma. Subsequent electroporation with tissue-specific CRISPR, targeting only tp53 was sufficient to induce transformation to melanoma. Our model exhibits the use of sequential mutagenesis in the adult zebrafish, and demonstrates that ZCCHC8-ROS1 induces a spectrum of melanocytic lesions that closely mimics human Spitz neoplasms. Summary: We describe the first animal model of Spitz neoplasms and demonstrate its use for modeling sequential mutagenesis and its potential for studying melanocyte development in vivo.
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Affiliation(s)
- Jeffrey K Mito
- Stem Cell Program and Division of Hematology/Oncology, Boston Children's Hospital, Boston, MA 02215, USA.,Department of Pathology, Brigham and Women's Hospital, Boston, MA 02215, USA
| | - Margaret C Weber
- Stem Cell Program and Division of Hematology/Oncology, Boston Children's Hospital, Boston, MA 02215, USA
| | - Alexandra Corbin
- Stem Cell Program and Division of Hematology/Oncology, Boston Children's Hospital, Boston, MA 02215, USA
| | - George F Murphy
- Department of Pathology, Brigham and Women's Hospital, Boston, MA 02215, USA
| | - Leonard I Zon
- Stem Cell Program and Division of Hematology/Oncology, Boston Children's Hospital, Boston, MA 02215, USA.,Department of Stem Cell and Regenerative Biology, Harvard University, Cambridge, MA 02138, USA.,Howard Hughes Medical Institute, Harvard Medical School, Boston, MA 02215, USA
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10
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Cheng TW, Ahern MC, Giubellino A. The Spectrum of Spitz Melanocytic Lesions: From Morphologic Diagnosis to Molecular Classification. Front Oncol 2022; 12:889223. [PMID: 35747831 PMCID: PMC9209745 DOI: 10.3389/fonc.2022.889223] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Accepted: 04/26/2022] [Indexed: 11/17/2022] Open
Abstract
Spitz tumors represent a distinct subtype of melanocytic lesions with characteristic histopathologic features, some of which are overlapping with melanoma. More common in the pediatric and younger population, they can be clinically suspected by recognizing specific patterns on dermatoscopic examination, and several subtypes have been described. We now classify these lesions into benign Spitz nevi, intermediate lesions identified as “atypical Spitz tumors” (or Spitz melanocytoma) and malignant Spitz melanoma. More recently a large body of work has uncovered the molecular underpinning of Spitz tumors, including mutations in the HRAS gene and several gene fusions involving several protein kinases. Here we present an overarching view of our current knowledge and understanding of Spitz tumors, detailing clinical, histopathological and molecular features characteristic of these lesions.
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Affiliation(s)
- Tiffany W. Cheng
- Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, MN, United States
| | - Madeline C. Ahern
- Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, MN, United States
| | - Alessio Giubellino
- Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, MN, United States
- Masonic Cancer Center, University of Minnesota, Minneapolis, MN, United States
- *Correspondence: Alessio Giubellino,
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11
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Church AJ, Moustafa D, Pinches RS, Hawryluk EB, Schmidt BAR. Genomic comparison of malignant melanoma and atypical Spitz tumor in the pediatric population. Pediatr Dermatol 2022; 39:409-419. [PMID: 35194848 DOI: 10.1111/pde.14935] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND/OBJECTIVES The diagnostic distinction between atypical Spitz tumor (AST) and malignant melanoma (MM) in pediatric tumors is challenging. Molecular tests are increasingly used to characterize these neoplasms; however, limited studies are available in pediatric patients. This study aimed to provide a genomic comparison of pediatric MM and AST in the context of comprehensive clinical annotation. METHODS Pediatric patients diagnosed with MM (n=11) and AST (n=12) were compared to a cohort of 693 adult melanoma patients. DNA next-generation sequencing assessed kinase gene fusions, tumor mutational burden, sequence variants, copy number alterations, structural variants, microsatellite instability, and mutational signatures. RESULTS Seven AST cases and eight MM cases were successfully sequenced. Kinase gene fusions were identified in both the MM and AST cohorts (NTRK1, ROS1, and MET). MM cases had TERT, BRAF, and CDKN2A alterations, which were not identified in the AST cohort. Tumor mutational burden (TMB) analysis showed pediatric ASTs had an average of 2.82 mutations/Mb, pediatric MM had an average of 5.7 mutations/Mb, and adult MM cases averaged 18.8 mut/Mb. One pediatric MM case had an elevated TMB of 15 mutations/Mb and a UV mutational signature. CONCLUSIONS These data expand our understanding of pediatric malignant melanoma. The differences between the molecular signatures for AST and MM are not statistically significant, and histopathology remains the gold standard for the diagnosis of pediatric AST and MM at this time. With more data, molecular studies may provide additional support for diagnosis and targeted therapeutics.
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Affiliation(s)
- Alanna J Church
- Harvard Medical School, Boston, Massachusetts, USA
- Department of Pathology, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Danna Moustafa
- Harvard Medical School, Boston, Massachusetts, USA
- Dermatology Section, Department of Immunology, Boston Children's Hospital, Boston, Massachusetts, USA
- Department of Dermatology, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Robert Seth Pinches
- Department of Pathology, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Elena B Hawryluk
- Harvard Medical School, Boston, Massachusetts, USA
- Dermatology Section, Department of Immunology, Boston Children's Hospital, Boston, Massachusetts, USA
- Department of Dermatology, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Birgitta A R Schmidt
- Harvard Medical School, Boston, Massachusetts, USA
- Department of Pathology, Boston Children's Hospital, Boston, Massachusetts, USA
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12
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Yeh I, Busam KJ. Spitz melanocytic tumours – a review. Histopathology 2021; 80:122-134. [DOI: 10.1111/his.14583] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2021] [Revised: 10/04/2021] [Accepted: 10/06/2021] [Indexed: 01/03/2023]
Affiliation(s)
- Iwei Yeh
- Department of Dermatology and Pathology University of California San Francisco CAUSA
| | - Klaus J Busam
- Department of Pathology Memorial Sloan Kettering Cancer Center New York NY USA
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13
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Bartenstein Reusch D, Hawryluk EB. Pigmented Lesions in Children: Update on Clinical, Histopathologic and Ancillary Testing. Dermatol Clin 2021; 40:25-36. [PMID: 34799033 DOI: 10.1016/j.det.2021.09.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Patients are commonly referred to pediatric dermatology for the evaluation of pigmented lesions. For families, pediatricians, and dermatologists alike, malignancy is the main fear. In the past few decades, there has been evolving literature to inform diagnosis and management. This article provides an update on the clinical, histopathologic, and ancillary testing for 3 categories of particularly challenging pigmented lesions: congenital melanocytic nevi, spitzoid neoplasms, and pediatric melanoma.
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Affiliation(s)
- Diana Bartenstein Reusch
- Harvard Combined Dermatology Residency Training Program, 50 Staniford Street, Suite 200, Boston, MA 02114, USA
| | - Elena B Hawryluk
- Department of Dermatology, Massachusetts General Hospital, 50 Staniford Street, Suite 200, Boston, MA 02114, USA; Dermatology Section, Boston Children's Hospital, Harvard Medical School, Boston, MA 02115, USA.
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14
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Kim DJ, Yuan TA, Chen PC, Liu-Smith F, Koh SS, Mesinkovska NA, Sarpa HG. Pediatric melanoma in the Hispanic population: An analysis of institutional and national data. Pediatr Dermatol 2021; 38:1102-1110. [PMID: 33486809 DOI: 10.1111/pde.14516] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
BACKGROUND/OBJECTIVES Pediatric melanoma is rare and remains poorly characterized, especially in racial/ethnic minorities of whom Hispanics are the largest and fastest growing in the United States. The health care burden of melanoma in Hispanics, who often present with more advanced disease, is rising and has even been called an early epidemic in California. We sought to document key clinicopathologic features of melanoma in Hispanic pediatric patients and to compare these parameters to pediatric non-Hispanic whites (NHWs) under the a priori hypothesis that Spitzoid melanomas occur in greater proportions in Hispanics. METHODS Single-institution cross-sectional study of pediatric melanoma cases (age < 20 years) with Hispanic stratification and comparison with matched Surveillance, Epidemiology, and End Results (SEER) data from the same time frame (1988-2016). RESULTS Of our 61 institutional cases of pediatric melanoma, Hispanics (11), compared with NHWs (40), presented significantly younger (11.7 years, 95% CI: 2.77-8.00 years; P = .001), with lower limb predominance (46%; P < .05), mostly Spitzoid melanomas (82%; P < .05), and thicker tumors (2.34 mm, CI: 0.26-2.19 mm; P < .05). Similarly, SEER data (2499 cases) showed greater proportions of childhood/pre-pubertal adolescent melanomas (<15 years), lower limb involvement, Spitzoid subtype (36.5% vs 22.5% in NHWs; P = .001), and advanced (regional/distant) disease stages in Hispanics (212) compared with NHWs (2197). CONCLUSIONS Pediatric melanomas may present differently in Hispanics, and heightened awareness/lower threshold to biopsy high-risk Spitzoid tumors on the lower limb may be warranted. Further investigations are needed to aid prevention and early detection in a vulnerable minority population less likely to seek outpatient dermatology specialty care.
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Affiliation(s)
- Dong Joo Kim
- Department of Dermatology, University of California, Irvine, CA, USA
| | - Tze-An Yuan
- Program in Public Health, University of California, Irvine, CA, USA
| | - Pin-Chun Chen
- Department of Statistics, Donald Bren School of Information & Computer Sciences, University of California, Irvine, CA, USA.,Department of Cognitive Sciences, School of Social Sciences, University of California, Irvine, CA, USA
| | - Feng Liu-Smith
- Department of Medicine, School of Medicine, University of California, Irvine, CA, USA.,Department of Epidemiology, School of Medicine, University of California, Irvine, CA, USA.,The Chao Family Comprehensive Cancer Center, University of California, Irvine, CA, USA
| | - Stephen Seongeun Koh
- Department of Pathology and Dermatopathology, Kaiser Permanente Anaheim/Irvine Medical Center, Anaheim, CA, USA
| | | | - Hege Grande Sarpa
- Department of Dermatology, University of California, Irvine, CA, USA.,Department of Dermatology, Southern California Kaiser Permanente Medical Group, Mission Viejo, CA, USA
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Abstract
Age plays a dynamic role in incidence, presentation, and extent of disease for cutaneous melanoma. Even within the spectrum of juvenile melanoma, there exists a range of spitzoid and nonspitzoid melanocytic and melanoma lesions. Spitzoid melanomas, a more favorable disease in juvenile patients, are malignant lesions and require treatment as such. Lymph node metastases in melanoma occur at lower rates in older patients compared with younger counterparts, yet the rate of metastases is still high. Age appears to play an important role in the development and progression of melanoma, and understanding the differences across age populations is important when counseling patients.
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Affiliation(s)
- Adrienne B Shannon
- Department of Surgery, Hospital of the University of Pennsylvania, 3400 Spruce Street, 4 Maloney, Philadelphia, PA 19104, USA.
| | - Yun Song
- Department of Surgery, Hospital of the University of Pennsylvania, 3400 Spruce Street, 4 Maloney, Philadelphia, PA 19104, USA
| | - Xiaowei Xu
- Department of Pathology and Laboratory Medicine, Hospital of the University of Pennsylvania, 3400 Spruce Street, 6 Founders, Philadelphia, PA 19104, USA
| | - Giorgos C Karakousis
- Department of Surgery, Hospital of the University of Pennsylvania, 3400 Spruce Street, 4 Silverstein, Philadelphia, PA 19104, USA
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16
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Cutaneous Melanomas Arising during Childhood: An Overview of the Main Entities. Dermatopathology (Basel) 2021; 8:301-314. [PMID: 34449585 PMCID: PMC8395919 DOI: 10.3390/dermatopathology8030036] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 07/11/2021] [Accepted: 07/12/2021] [Indexed: 12/28/2022] Open
Abstract
Cutaneous melanomas are exceptional in children and represent a variety of clinical situations, each with a different prognosis. In congenital nevi, the risk of transformation is correlated with the size of the nevus. The most frequent type is lateral transformation, extremely rare before puberty, reminiscent of a superficial spreading melanoma (SSM) ex-nevus. Deep nodular transformation is much rarer, can occur before puberty, and must be distinguished from benign proliferative nodules. Superficial spreading melanoma can also arise within small nevi, which were not visible at birth, usually after puberty, and can reveal a cancer predisposition syndrome (CDKN2A or CDK4 germline mutations). Prognosis is correlated with classical histoprognostic features (mainly Breslow thickness). Spitz tumors are frequent in adolescents and encompass benign (Spitz nevus), intermediate (atypical Spitz tumor), and malignant forms (malignant Spitz tumor). The whole spectrum is characterized by specific morphology with spindled and epithelioid cells, genetic features, and an overall favorable outcome even if a regional lymph node is involved. Nevoid melanomas are rare and difficult to diagnose clinically and histologically. They can arise in late adolescence. Their prognosis is currently not very well ascertained. A small group of melanomas remains unclassified after histological and molecular assessment.
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Abstract
Pediatric tumors can be divided into hematologic malignancies, central nervous system tumors, and extracranial solid tumors of bone, soft tissue, or other organ systems. Molecular alterations that impact diagnosis, prognosis, treatment, and familial cancer risk have been described in many pediatric solid tumors. In addition to providing a concise summary of clinically relevant molecular alterations in extracranial pediatric solid tumors, this review discusses conventional and next-generation sequencing-based molecular techniques, relevant tumor predisposition syndromes, and the increasing integration of molecular data into the practice of diagnostic pathology for children with solid tumors.
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Affiliation(s)
- Jonathan C Slack
- Department of Pathology, Boston Children's Hospital, Harvard Medical School, 300 Longwood Avenue, Boston, MA 02115, USA
| | - Alanna J Church
- Department of Pathology, Boston Children's Hospital, Harvard Medical School, 300 Longwood Avenue, Boston, MA 02115, USA.
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18
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Sondak VK, Messina JL. What's new in pediatric melanoma and Spitz tumors? Pretty much everything. Cancer 2021; 127:3720-3723. [PMID: 34228362 DOI: 10.1002/cncr.33749] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Accepted: 05/24/2021] [Indexed: 12/25/2022]
Abstract
LAY SUMMARY Pathologists sometimes have great difficulty in determining whether a mole biopsied from the skin of a child is benign or malignant. New molecular technologies have helped pathologists to identify pediatric melanomas, but there are still some atypical moles that cannot be definitively classified as benign or malignant. With further research, it is hoped that the number of these atypical tumors can be decreased and that the treatment for all children with moles and melanoma can be improved.
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Affiliation(s)
- Vernon K Sondak
- Department of Cutaneous Oncology, Moffitt Cancer Center, Tampa, Florida
| | - Jane L Messina
- Department of Cutaneous Oncology, Moffitt Cancer Center, Tampa, Florida.,Department of Anatomic Pathology, Moffitt Cancer Center, Tampa, Florida
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19
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Vaccaro M, Marafioti I, Giuffrida R, Borgia F, Zalaudek I. Clinical and dermoscopic characterization of pediatric Spitz nevi of the ear. Pediatr Dermatol 2021; 38:895-898. [PMID: 34152025 DOI: 10.1111/pde.14616] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Spitz nevi of special sites, such as the ear, appear rarely and pose a challenge with worrisome clinical, dermoscopic, or histopathological features. Our aim was to evaluate the morphological findings of a series of Spitz nevi of the ear in order to obtain more knowledge about their clinical-dermoscopic patterns. Of a total of six cases, three main dermoscopic structures were found: pseudonetwork, structureless areas, and cobblestone pattern. Our preliminary findings suggest that dermoscopy may be helpful in improving the diagnostic accuracy of Spitz nevus of the ear and minimize surgery in a sensitive location.
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Affiliation(s)
- Mario Vaccaro
- Department of Clinical and Experimental Medicine, Dermatology- University of Messina, Messina, Italy.,Department of Dermatology and Venereology, University of Trieste, Trieste, Italy
| | - Ilenia Marafioti
- Department of Clinical and Experimental Medicine, Dermatology- University of Messina, Messina, Italy.,Department of Dermatology and Venereology, University of Trieste, Trieste, Italy
| | - Roberta Giuffrida
- Department of Clinical and Experimental Medicine, Dermatology- University of Messina, Messina, Italy.,Department of Dermatology and Venereology, University of Trieste, Trieste, Italy
| | - Francesco Borgia
- Department of Clinical and Experimental Medicine, Dermatology- University of Messina, Messina, Italy.,Department of Dermatology and Venereology, University of Trieste, Trieste, Italy
| | - Iris Zalaudek
- Department of Dermatology and Venereology, University of Trieste, Trieste, Italy
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20
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Bobos M. Histopathologic classification and prognostic factors of melanoma: a 2021 update. Ital J Dermatol Venerol 2021; 156:300-321. [PMID: 33982546 DOI: 10.23736/s2784-8671.21.06958-3] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Despite the rapid recent advances in molecular analysis of tumors, which allow large-scale and high-resolution genomics, the "gold standard" for melanoma diagnosis continues to be histopathology, in conjunction with clinical characteristics and sometimes with important support of immunohistochemistry. Observations, where postulated that cutaneous melanomas may arise through two distinct pathways, discoveries such as that BRAFV600E mutations were mostly common in melanomas on sun-exposed skin with little solar elastosis and seminal works for melanoma progression and evolution set the groundwork for the new WHO Classification of Melanoma: a classification of melanoma that not only encompasses histologic but also clinical, epidemiologic, and genetic characteristics. The melanomas were divided into those etiologically related to sun exposure and those that are not, based on their mutational signatures, anatomic site, and epidemiology. On the basis of degree of associated solar elastosis melanomas on the sun exposed skin were further divided by the histopathologic degree of cumulative solar damage (CSD) of the surrounding skin, into low and high CSD. On the low-CSD group of melanomas are included superficial spreading melanomas, while the high-CSD melanomas encompasses lentigo maligna and desmoplastic melanomas. The "non-CSD" classification includes acral melanomas, some melanomas in congenital nevi, melanomas in blue nevi, Spitz melanomas, mucosal melanomas, and uveal melanomas. Nodular and nevoid melanoma may occur in any pathway. A group of intermediate tumors termed melanocytoma is proposed for tumors that in addition to mutations that activate the MAPK pathway, harbor multiple driver mutations, and they are either low-grade or high-grade, to indicate that they may carry a higher risk of malignant transformation. In this review a summary of the most recent WHO classification of melanoma is provided. A short analysis of essential histopathologic prognostic parameters is also provided. The new classification of melanoma discriminates distinct types of melanoma based on their clinicopathologic, and genomic characteristics. Undoubtedly, melanoma research will continue to evolve as new clinical, pathological, molecular data accumulates. The challenge of the forthcoming years is to better characterize the intermediate category of melanocytic lesions.
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Affiliation(s)
- Mattheos Bobos
- Department of Biomedical Sciences, School of Health Sciences, International Hellenic University, Alexandrian Campus, Sindos, Thessaloniki, Greece -
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21
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Management of Residual Spitz Nevus in Surgical Specimens following Biopsy and Excision. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2020; 8:e3244. [PMID: 33425580 PMCID: PMC7787304 DOI: 10.1097/gox.0000000000003244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 09/18/2020] [Indexed: 11/26/2022]
Abstract
Proper management of Spitz nevi continues to be debated, with treatment ranging from observation to surgery. To better characterize the outcome of surgical procedures performed for incomplete initial excision or biopsy, we sought to ascertain the histopathological presence of residual Spitz nevi in a set of surgical specimens. Methods We retrospectively reviewed 123 records with histologically-confirmed Spitz nevus. Data concerning treatment, clinical features, histopathological margin involvement, and presence of residual lesion on subsequent procedural specimens were collected. Results Fifty-three percent of lesions (n = 65) were initially sampled by shave or punch biopsy, and the remainder (n = 58) were formally excised without initial biopsy. The rates of re-excision for involved margins were: shave biopsy (92.2%), punch biopsy (78.6%), and formal excision (13.8%). In total, 61.0% of patients who underwent an initial procedure of any kind had involved margins, but only half of those re-excised for involved margins (57.6%) had histologically residual lesion on repeated excision. A significantly higher proportion of initial punch biopsies (90.9%) resulted in residual lesion (in secondary excision specimens) when compared with shave biopsy (48.9%) and formal excision (62.5%; P < 0.05). Conclusions Findings suggest that clinicians may consider shave biopsy over punch biopsy for diagnosing suspected lesions, when indicated and appropriate. Given the rarity of malignant transformation and the frequency of residual nevus, observation may be reasonable for managing pediatric patients with histologically-confirmed Spitz nevi, who are post initial biopsy or excision despite known histopathological margin involvement.
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22
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Davies OMT, Majerowski J, Segura A, Kelley SW, Sokumbi O, Humphrey SR. A sixteen-year single-center retrospective chart review of Spitz nevi and spitzoid neoplasms in pediatric patients. Pediatr Dermatol 2020; 37:1073-1082. [PMID: 32857447 DOI: 10.1111/pde.14320] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2020] [Revised: 06/22/2020] [Accepted: 07/14/2020] [Indexed: 12/28/2022]
Abstract
BACKGROUND Spitzoid neoplasms in pediatric patients pose an interesting challenge for clinicians. More data on the clinical, histologic, and molecular characteristics of these lesions are necessary to distinguish features that may portend recurrence or malignant behavior to help determine future treatment guidelines in pediatric patients. METHODS Institutional Review Board approval was obtained from Children's Hospital of Wisconsin to conduct a retrospective analysis of spitzoid neoplasms. Patients with biopsied or excised spitzoid neoplasms between 01/01/2000 and 08/01/2016 were included. Pertinent clinical and histologic data were collected. Atypical, unusual, or diagnostically uncertain lesions were selected for re-review. RESULTS 266 lesions from 264 patients were included. 243 were classified as benign (91.35%), 22 as atypical (8.27%), and 1 as spitzoid melanoma (0.38%). No clinical or histologic variables were found to be statistically significant between the benign Spitz, atypical Spitz, and spitzoid melanoma cohorts. No known deaths occurred. CONCLUSION Our findings highlight the extreme variability of spitzoid neoplasms clinically and histologically. Importantly, this study demonstrates that the vast majority of spitzoid neoplasms in pediatric populations are benign and supports conservative management of spitzoid lesions in children.
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Affiliation(s)
| | | | - Annette Segura
- Department of Pathology, Medical College of Wisconsin, Milwaukee, WI, USA
| | | | - Olayemi Sokumbi
- Departments of Dermatology and Laboratory Medicine & Pathology, Mayo Clinic, Jacksonville, FL, USA
| | - Stephen R Humphrey
- Department of Dermatology, Medical College of Wisconsin, Milwaukee, WI, USA
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23
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Hawryluk EB, Moustafa D, Bartenstein D, Brahmbhatt M, Cordoro K, Gardner L, Gauthier A, Grossman D, Gupta D, Hunt RD, Jen M, Kao PC, Kruse LL, Lawley LP, London WB, Mansour D, O'Haver JA, Phung T, Pope E, Price HN, Rogers T, Shah SD, Wolner Z, Huang J, Marghoob AA. A retrospective multicenter study of fatal pediatric melanoma. J Am Acad Dermatol 2020; 83:1274-1281. [DOI: 10.1016/j.jaad.2020.06.1010] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 06/23/2020] [Accepted: 06/29/2020] [Indexed: 10/23/2022]
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24
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Valdivielso-Ramos M, Roldan D, Alonso S. Verrucous Spitz Nevus. J Pediatr 2020; 226:307-308. [PMID: 32663592 DOI: 10.1016/j.jpeds.2020.07.035] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 06/30/2020] [Accepted: 07/08/2020] [Indexed: 11/29/2022]
Affiliation(s)
| | - David Roldan
- Pathology Department, Infanta Leonor Hospital, Madrid, Spain
| | - Soledad Alonso
- Pathology Department, Infanta Leonor Hospital, Madrid, Spain
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25
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Hawryluk EB, Duncan LM. The evolving nomenclature of spitzoid proliferations-Pediatric outcomes are favorable, regardless of name. Pediatr Dermatol 2020; 37:1083-1084. [PMID: 33283923 DOI: 10.1111/pde.14461] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Accepted: 10/27/2020] [Indexed: 01/04/2023]
Affiliation(s)
- Elena B Hawryluk
- Harvard Medical School, Boston, MA, USA.,Department of Dermatology, Massachusetts General Hospital, Boston, MA, USA
| | - Lyn M Duncan
- Harvard Medical School, Boston, MA, USA.,Pathology Service, Massachusetts General Hospital, Boston, MA, USA
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26
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Kaushik A, Natsis N, Gordon SC, Seiverling EV. A practical review of dermoscopy for pediatric dermatology part I: Melanocytic growths. Pediatr Dermatol 2020; 37:789-797. [PMID: 32748996 DOI: 10.1111/pde.14291] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
The value of dermoscopy in the detection of skin cancer is well established. Less is published on the utility of dermoscopy in the evaluation of pediatric skin disease. Our review (in two parts) aims to serve as an update on pediatric dermoscopy and to provide readers with a practical application for the use of dermoscopy in pediatric dermatology clinics. In part I, we propose a dermoscopy algorithm for pediatric skin disease and melanocytic growths, and in part II, we address vascular growths, common skin infections, and inflammatory conditions for which dermoscopy is valuable.
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Affiliation(s)
- Anshika Kaushik
- Division of Pediatric and Adolescent Dermatology, Rady Children's Hospital-San Diego, San Diego, CA, USA.,Department of Dermatology, University of California San Diego School of Medicine, San Diego, CA, USA
| | - Nicola Natsis
- Division of Pediatric and Adolescent Dermatology, Rady Children's Hospital-San Diego, San Diego, CA, USA.,University of California San Diego School of Medicine, San Diego, CA, USA
| | | | - Elizabeth V Seiverling
- Department of Dermatology, Tufts Medical Center, Boston, MA, USA.,Division of Dermatology, Maine Medical Center & Maine Medical Partners, Portland, ME, USA
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27
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Ruijter CGH, Ouwerkerk W, Jaspars EH, van Doorn R, Luiten RM, Bekkenk MW, Tio DCKS. Incidence and outcome of Spitzoid tumour of unknown malignant potential (STUMP): an analysis of cases in the Netherlands from 1999 to 2014. Br J Dermatol 2020; 183:1121-1123. [PMID: 32628276 DOI: 10.1111/bjd.19383] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 06/30/2020] [Accepted: 06/30/2020] [Indexed: 02/06/2023]
Affiliation(s)
- C G H Ruijter
- Departments of, Department, Dermatology, Amsterdam, Amsterdam, the Netherlands
| | - W Ouwerkerk
- Departments of, Department, Dermatology, Amsterdam, Amsterdam, the Netherlands
| | - E H Jaspars
- Department, Pathology, Amsterdam UMC, Amsterdam, The Netherlands
| | - R van Doorn
- Department of Dermatology, Leiden Universitair Medisch Centrum, Leiden, The Netherlands
| | - R M Luiten
- Departments of, Department, Dermatology, Amsterdam, Amsterdam, the Netherlands
| | - M W Bekkenk
- Departments of, Department, Dermatology, Amsterdam, Amsterdam, the Netherlands
| | - D C K S Tio
- Departments of, Department, Dermatology, Amsterdam, Amsterdam, the Netherlands
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28
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Abstract
PURPOSE OF REVIEW To inform pediatric providers of the clinical characteristics, underlying genetic drivers, and therapeutic options for skin cancer arising in childhood and adolescence. RECENT FINDINGS The incidence of melanoma in pediatric patients has been declining in the past decades. Pediatric-specific diagnostic criteria should be utilized when assessing lesions concerning for melanoma to better account for the different presentations seen in pediatric disease compared with adults, such as an increased prevalence of amelanotic melanoma or frequent mimic of benign pediatric lesions. Pediatric melanoma often presents with a higher histopathologic stage and a higher Breslow depth as compared with adult melanoma. Pediatric nonmelanoma skin cancer including basal cell carcinoma and squamous cell carcinoma are associated with genetic conditions and immunosuppression, both iatrogenic and inherited. SUMMARY Melanoma in pediatric patients often presents differently from conventional adult melanoma, including Spitz melanoma and melanoma associated with congenital melanocytic nevi. Pediatric patients with nonmelanoma skin cancers should be evaluated for predisposing risk factors. More research on therapeutic options for pediatric skin cancer is vital to understanding the tolerance and response of our pediatric patients to therapies that are more frequently utilized in adult disease.
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Affiliation(s)
- Danna Moustafa
- Harvard Medical School, Boston, Massachusetts, USA.,Department of Dermatology, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Holly Neale
- University of Massachusetts School of Medicine, Worcester, Massachusetts, USA
| | - Elena B Hawryluk
- Harvard Medical School, Boston, Massachusetts, USA.,Department of Dermatology, Massachusetts General Hospital, Boston, Massachusetts, USA
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29
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Quoi de neuf en dermatologie pédiatrique ? Ann Dermatol Venereol 2019; 146:12S32-12S38. [DOI: 10.1016/s0151-9638(20)30104-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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30
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Affiliation(s)
- D E Elder
- Hospital of the University of Pennsylvania, 3400 Spruce St, Philadelphia, PA, 19104, U.S.A
| | - R L Barnhill
- Institut Curie, 26 rue d'Ulm, 75005, Paris, France
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