engleski

Epidemiological and clinical characteristics of patients with Spitz tumors - a single center retrospective study

Spitz tumors are a subgroup of melanocytic neoplasms with distinctive histopathological features, with the term “spitzoid” referring to the epithelioid or spindled morphology of melanocytes. These tumors typically occur in children and young adults, and comprise a spectrum of skin lesions ranging from benign Spitz nevi to malignant melanoma. Significant category within the spectrum is that of atypical Spitz tumors (AST) with uncertain malignant potential (STUMP). These cannot be easily categorized as benign or malignant based upon clinical, dermatoscopical or even by conventional microscopic criteria. There is also a lack of uniform guidelines for diagnostic workup and further management of patients with AST.We conducted a retrospective analysis of patients with suspected, excised and histopathologically confirmed Spitz tumors diagnosed in the Clinical Hospital Center Rijeka, Croatia during a period from January 2015 to March 2022. Methods of descriptive statistics were used for processing data. During the study period, there were 282 clinically suspected Spitz tumors of which 44% were confirmed by histopathology. Of these, 49.2% of lesions occurred in male patients. Median age at diagnosis was 19 years in male patients, and 32 years in female patients. Localization of tumors was similar for both genders. In female patients, most Spitz tumors were located on the back (34.9%), whereas in men they most commonly occurred on the arm (39.3%). Face was the least frequent site in both genders (3.3% of lesions in male and 3.1% in female patients). Histopathologically, final diagnosis was that of a Spitz nevus in 52.4% of cases, Reed nevus in 13%, AST in 6.5% and spitzoid melanoma in 7.2% of cases. In men, the category of Spitz nevus predominated (62.3%), unlike in women, where AST prevailed (49.2%). Spitzoid melanoma was a final diagnosis in 3.3% of cases in male patients, and 7.9% of cases in female patients. None of the AST lesions metastasized throughout the follow up period. Our data are mostly in concordance with the epidemiological data on Spitz nevi and AST available in the literature. According to the literature, there is a slightly higher prevalence of Spitz tumors in women, but in our study, tumors occurred with similar frequency in both genders.. Spitzoid melanocytic neoplasms still represent a diagnostically challenging group of melanocytic lesions, with uncertainties regarding their biological behavior and clinical outcomes of patients. Given the fact that most lesions occur in pediatric population, this poses a phycological burden for patients and their families, but also a challenge for the clinicians included in the management and follow up of the patients. Therefore, there is a need for more studies regarding the clinical, demographic, histopathological, immunohistochemical, and genetic variables related to Spitz tumors, including the long-term clinical outcomes and ultimately the most appropriate therapeutic approach for the affected patients.

Spitz nevus ; melanoma

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