title: The surgical management of Spitz naevi and atypical spitzoid neoplasms: A review of the literature.
abstract: Melanocytic lesions with spitzoid differentiation represent a difficult management paradigm. Spitzoid lesions form a spectrum of distinct entities encompassing Spitz naevi, atypical Spitz naevi and spitzoid melanoma which range from benign to malignant. Differentiation between benign and malignant lesions can be challenging making surgical management difficult. In this article we highlight clinical conundrums regarding Spitz naevi. We review the literature in terms of the newer histological tools available to more explicitly classify these lesions which may have an impact on the clinical care that these patients receive. The article also examines the controversy which surrounds the role of sentinel lymph node biopsy (SLNB) and completion lymph node dissection in the management of melanocytic proliferations with Spitz differentiation.
authors.affiliation: Department of Surgery, Beaumont Hospital and Royal College of Surgeons, Beaumont Road, Dublin 9, Ireland. doireannjoyce@rcsi.ie
authors.forename: D P
authors.initials: DP
authors.lastname: Joyce
authors.forename: R S
authors.initials: RS
authors.lastname: Prichard
authors.forename: C
authors.initials: C
authors.lastname: Gulmann
authors.forename: A D K
authors.initials: AD
authors.lastname: Hill
mesh_terms: D062109:Dermatologic Surgical Procedures / Q000379:methods*; D003937:Diagnosis, Differential; D006801:Humans; D008197:Lymph Node Excision / Q000379:methods*; D008207:Lymphatic Metastasis; D018332:Nevus, Epithelioid and Spindle Cell / Q000175:diagnosis / Q000601:surgery*; D021701:Sentinel Lymph Node Biopsy; D012878:Skin Neoplasms / Q000175:diagnosis / Q000556:secondary / Q000601:surgery*
keywords: Atypical spitzoid neoplasms; Complete lymph node dissection; Sentinel lymph node biopsy; Spitz naevi