title: Melanoma mimic: a case of multiple pagetoid Spitz nevi.
abstract: BACKGROUND
  Differentiating Spitz nevi from melanoma can be difficult. Pagetoid spread of melanocytes is among the features making diagnosis difficult. Rare reports of isolated pagetoid Spitz nevi exist.
  
  
  METHODS
  We present a unique case of multiple pagetoid Spitz nevi initially diagnosed as multiple in situ melanomas. Germline karyotyping, CDK4 and CDKN2A sequencing, and comparative genomic hybridization of HRAS, BRAF, KRAS, RAF1, CDKN2A, Rb1, MAP2K1, MAP2K2, PTEN, and PTPN11 genes did not identify mutations in this case. Germline and somatic sequencing of BRAF exon 15 revealed no mutations at V600D/E/K. In addition, single-nucleotide polymorphism microarray analysis (330K) on lesional and normal skin revealed no genome-wide copy number changes or loss of heterozygosity.
  
  
  CONCLUSIONS
  Clinicians should be aware of the occurrence of multiple pagetoid Spitz nevi to avoid morbidity associated with the misdiagnosis of multiple melanomas. The genetic mechanisms of pagetoid spread of melanocytes are not fully understood.
authors: Department of Dermatology, University of Utah , Salt Lake City, UT 84112, USA.
authors: KaLynne
authors: K
authors: Harris
authors: Scott R
authors: SR
authors: Florell
authors: Jason
authors: J
authors: Papenfuss
authors: Wendy
authors: W
authors: Kohlmann
authors: Mona
authors: M
authors: Jahromi
authors: Joshua D
authors: JD
authors: Schiffman
authors: John
authors: J
authors: Quackenbush
authors: Pamela
authors: P
authors: Cassidy
authors: Sancy
authors: S
authors: Leachman
mesh_terms: D000328:Adult; D001706:Biopsy; D002278:Carcinoma in Situ / Q000175:diagnosis* / Q000235:genetics / Q000473:pathology; D004252:DNA Mutational Analysis; D003937:Diagnosis, Differential; D005260:Female; D055106:Genome-Wide Association Study; D006801:Humans; D007621:Karyotyping; D008545:Melanoma / Q000175:diagnosis* / Q000235:genetics / Q000473:pathology; D009378:Neoplasms, Multiple Primary / Q000175:diagnosis* / Q000235:genetics / Q000473:pathology; D018332:Nevus, Epithelioid and Spindle Cell / Q000175:diagnosis* / Q000235:genetics / Q000473:pathology; D012867:Skin / Q000473:pathology; D012878:Skin Neoplasms / Q000175:diagnosis* / Q000235:genetics / Q000473:pathology