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- Title
Atypical spitzoid tumors in young patients. Evaluation and diagnosis.
- Authors
Purcari, Luiza; Bădic, Cristina; Potop, Roxana; Stan, Daniela; Pîslariu, Anca; Iaciu, Cristian; Nițipir, Cornelia
- Abstract
Background. The Spitz nevus and the spitzoid malignant melanoma represent the two ends of the spitzoid lesion spectrum. The atypical spitzoid neoplasias represent an ambiguous clinical category which includes lesions presenting both benign and malignant histologic characteristics. Therefore, these tumors remain a challenge for the pathologists, given the fact that a clear prediction of the future behavior of the tumor is difficult, if not impossible. Some tumors will metastasize and will have a poor prognosis, some will present no metastatic behavior and will have an indolent evolution, and some will metastasize modestly and exclusively to the locoregional lymph nodes. Case description. This paper presents a case of an atypical spitzoid tumor in a 21yearold patient with no significant personal or familial family history which expressed borderline characteristics between benign and malignant lesions. The patient underwent SLNB, with a positive result for an isolated micrometastasis and the biopsy material was further tested for molecular and genetic abnormalities. Complete lymph node dissec tion was performed and consequent adjuvant treatment with immune checkpoint inhibitors was initiated. The case aims at emphasizing the challenges that these tumors imply in terms of diagnosis and further treatment. Conclusions. Borderline melanocytic tumors represent a challenge for the oncological field, due to their unpredictive behavior. Between the two concepts of primum non nocere and precaution is better than curing, it is important to take a collective decision, including patients, their families and the specialists with a high expertise level in this field. How far should reach the treatment choice is yet unknown and should be carefully decided upon. Seeking a second opinion is therefore indicated in these difficult to define cases. Further research is needed to better define predictive factors and to separate between histologic categories.
- Subjects
DIAGNOSIS; PHYLLODES tumors; MELANOMA; IMMUNE checkpoint inhibitors; PROGNOSIS; IMMUNOLOGICAL adjuvants
- Publication
Oncolog-Hematolog, 2021, Issue 55, p45
- ISSN
2066-8716
- Publication type
Article