Cervical metastasis from Spitz nevus of the buccal mucosa.
A 23-year-old woman was presented with a prolonged history of a small lump in the buccal mucosa. A local excision was performed. The morphology diagnosed a Spitz nevus and she underwent supplementary excision of scar tissue. Two years later a submandibular lump appeared on the ipsilateral side of the neck. Cytology from fine needle aspiration indicated spread of a melanocytic tumor and she underwent a modified supraomohyiod neck dissection. One of the lymph nodes showed an inclusion of cells in the deep layers with epitheloid and spindle cells in a pattern similar to that of the primary oral lesion. The finding suggests a mechanical spread of melanocytes from the Spitz nevus to the regional lymph node. After more than 3 years of follow-up there is no further manifestation of disease. It is believed that this may be an example of how a Spitz tumor, although inherently benign, can spread along lymphatics in a pseudometastatic fashion. To our knowledge this is the first report of an oral Spitz melanoma with metastatic behavior.
Zätterström
Ulf
U
Departments of aOto-Rhino-Laryngology/Head and Neck Surgery,Rikshospitalet Medical Center, University of Oslo, Oslo, Norway. ulf.zatterstrom@rikshospitalet.no
Thor
Andreas
A
Nordgren
Hans
H
D000328:Adult; D005260:Female; D006258:Head and Neck Neoplasms / Q000556:secondary* / Q000601:surgery; D006801:Humans; D008207:Lymphatic Metastasis; D009061:Mouth Mucosa / Q000473:pathology* / Q000601:surgery; D009062:Mouth Neoplasms / Q000473:pathology* / Q000601:surgery; D037981:Neck Dissection; D018332:Nevus, Epithelioid and Spindle Cell / Q000473:pathology* / Q000601:surgery; D009508:Nevus, Pigmented / Q000473:pathology