title: Spitzoid melanoma and micrometastases in two lymph node regions: a critical situation.
abstract: Atypical Spitz tumors can hardly be differentiated from spitzoid melanoma. CGH might help in the differential diagnosis. An 8 year old child with an atypical Spitz tumor (with a CGH pattern compatible with melanoma) of 8.0 mm Breslow thickness and micrometastases in two lymph node regions was seen at our department. The management and prognosis of atypical Spitz tumors is controversial, and aggressive procedural steps similar to melanoma are usually not recommended. Even performing sentinel lymph node biopsy has been questioned. After extensive interdisciplinary consultations, we did not recommend resection of both lymph node regions and chose instead to follow-up with regular whole-body MRI and adjuvant treatment with pegylated interferon. Treatment decisions for atypical Spitz tumors are a major medical and ethical challenge due to the limited available data.
authors.affiliation: Department of Dermatology, University Hospital Zurich, Gloriastrasse 31, 8091 Zurich, Switzerland.
authors.forename: Alexander A
authors.initials: AA
authors.lastname: Navarini
authors.forename: Jürgen
authors.initials: J
authors.lastname: Bauer
authors.forename: Marjam J
authors.initials: MJ
authors.lastname: Barysch
authors.forename: Werner
authors.initials: W
authors.lastname: Kempf
authors.forename: Daniela
authors.initials: D
authors.lastname: Mihic-Probst
authors.forename: Katrin
authors.initials: K
authors.lastname: Kerl
authors.forename: Jivko
authors.initials: J
authors.lastname: Kamarashev
authors.forename: Pietro
authors.initials: P
authors.lastname: Giovanoli
authors.forename: Antonios G A
authors.initials: AG
authors.lastname: Kolios
authors.forename: Eva
authors.initials: E
authors.lastname: Bergstraesser
authors.forename: Reinhard
authors.initials: R
authors.lastname: Dummer
mesh_terms: D002648:Child; D055028:Comparative Genomic Hybridization; D056915:DNA Copy Number Variations; D006801:Humans; D008207:Lymphatic Metastasis; D008545:Melanoma / Q000235:genetics / Q000473:pathology* / Q000628:therapy; D018332:Nevus, Epithelioid and Spindle Cell / Q000235:genetics / Q000473:pathology* / Q000628:therapy; D012878:Skin Neoplasms / Q000235:genetics / Q000473:pathology* / Q000628:therapy