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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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