title: [Amelanotic spitzoid melanoma of the digit: case report].
abstract: BACKGROUND
  Melanomas of digit is rare, accounting for 1% of all cutaneous melanomas. We report a new case.
  
  
  OBJECTIVE
  Our purpose is to discuss the clinicopathological characteristics and the difficulties encountred in establishing diagnosis of this rare tumor.
  
  
  METHODS
  we report the case of a 25-years-old woman, who consulted for nodular and ulcerated lesion of the right index, located in the external face of the metacarpo-phalangeal joint. The nodule was biopsied and histopathologic exam concluded to spitzoid melanoma. The surgical margins were involved. The patient refused surgical recovery. She consulted 3 years later with axillary lymph nodes. A wide excision of the tumor with lymph node biopsy were made. Histological study concluded to a tumoral residu incompletely excided with lymph node metastases. Amputation of the second digit with dissection of the axillary lymph nodes was made. The surgical margins were tumor free. Lung metastases appeared with a follow up of two months. The patient died early after starting chemotherapy with Deticen.
  
  
  CONCLUSIONS
  In our report, clinical presentation was misleading causing a diagnosis and therapeutic delay. Pathologically, all the histological types of melanoma were described in the digit except spitzoid melanoma.
authors.affiliation: Laboratoire d'Anatomie et de Cytologie Pathologiques, CHU Habib Bourguiba, Sfax-Tunisie.
authors.forename: L
authors.initials: L
authors.lastname: Ayadi
authors.forename: C
authors.initials: C
authors.lastname: Chaari
authors.forename: A
authors.initials: A
authors.lastname: Masmoudi
authors.forename: A
authors.initials: A
authors.lastname: Khabir
authors.forename: A
authors.initials: A
authors.lastname: Masmoudi
authors.forename: Z
authors.initials: Z
authors.lastname: Ellouze
authors.forename: H
authors.initials: H
authors.lastname: Turki
authors.forename: H
authors.initials: H
authors.lastname: Keskes
authors.forename: M
authors.initials: M
authors.lastname: Frikha
authors.forename: S
authors.initials: S
authors.lastname: Makni
authors.forename: T
authors.initials: T
authors.lastname: Sellami Boudawara
mesh_terms: D000328:Adult; D000671:Amputation, Surgical; D005260:Female; D005385:Fingers / Q000473:pathology* / Q000601:surgery; D006801:Humans; D018328:Melanoma, Amelanotic / Q000473:pathology* / Q000601:surgery; D012878:Skin Neoplasms / Q000473:pathology* / Q000601:surgery