ORIGINAL ARTICLE   

Giornale Italiano di Dermatologia e Venereologia 2019 June;154(3):315-20

DOI: 10.23736/S0392-0488.17.05575-4

Copyright © 2017 EDIZIONI MINERVA MEDICA

language: English

The large spectrum of Spitzoid tumors: a retrospective survival study

Paolo BROGANELLI ¹, Simone RIBERO ¹ ✉, Ilaria CASTAGNO ², Fulvio RICCERI ^{3, 4}, Tommaso DEBOLI ², Elena MARRA ², Carlo TOMASINI ⁵, Carlotta SACERDOTE ⁶, Simona OSELLA-ABATE ⁷, Martina SANLORENZO ⁸, Pietro QUAGLINO ¹, Maria T. FIERRO ¹

¹ Dermatologic Clinic Department of Medical Sciences, University of Turin, Turin, Italy; ² Department of Oncology and Dermatology, City of Health and Science, University of Turin, Turin, Italy; ³ Unit of Cancer Epidemiology, Department of Medical Sciences, City of Health and Science, University of Turin, Turin, Italy; ⁴ Unit of Epidemiology, Regional Health Service ASLTO3, Grugliasco, Turin, Italy; ⁵ Department of Clinical-Surgical, Diagnostic and Pediatric Science, Institute of Dermatology, Fondazione IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy; ⁶ Unit of Cancer Epidemiology, Department of Medical Sciences, City of Health and Science, University of Turin, Turin, Italy; ⁷ Section of Surgical Pathology, Department of Medical Sciences, University of Turin, Turin, Italy; ⁸ Department of Medicinee I, Comprehensive Cancer Center, Institute of Cancer Research, Medical University of Vienna, Vienna, Austria

BACKGROUND: There is no universally-accepted classification of Spitzoid tumors. This makes it difficult to assign a correct diagnosis and select a treatment that minimizes the risk of overestimating, or worse, underestimating, the malignant potential of these tumors. The aim of this study was to describe the clinical-pathological and epidemiological features of Spitzoid tumors, as well as to assess mortality in these patients.
METHODS: This retrospective cohort study looked at data on Spitzoid tumors excised in 1999-2012 at the Dermatologic Clinic of the Turin University Hospital. Spitzoid melanoma specific survival curves were generated with the Kaplan-Meier method and compared using the log-rank test.
RESULTS: In this time period, 1663 lesion were described at the pathologic report as Spitzoid. 262 (15.75%) were Spitz nevi, 307 (18.46%) Reed nevi, 827 (49.73%), 810 (48.71%) Spitzoid dysplastic nevi, 17(1.02%) atypical Spitzoid tumors, and 267 (16.06%) Spitzoid melanomas. Median follow-up time was 9 years. Out of the entire cohort only 24 patients died from melanoma. All of them received a diagnosis of Spitzoid melanoma. None of the patients with a diagnosis of not melanoma Spitz tumor died for melanoma during the follow-up.
CONCLUSIONS: In the large majority of the cases, Spitz tumor should be considered as benign lesion and excised only if melanoma features are seen. The used clinical pathological classification avoid misdiagnoses, inappropriate treatment and the risk of death for melanoma.

KEY WORDS: Nevus, epithelioid and spindle cell; Neoplasms; Survival