Ann Dermatol.  2015 Apr;27(2):206-209. 10.5021/ad.2015.27.2.206.

A Case of Spitzoid Melanoma

• Kim HY
• Yoon JH
• Cho EB
• Park EJ
• Kim KH
• Kim KJ

• KMID: 2264813
• DOI: http://doi.org/10.5021/ad.2015.27.2.206

Abstract

Spitzoid melanoma is a subtype of melanoma that, clinically and histologically, resembles a Spitz nevus. Clinically, spitzoid melanomas usually evolve from amelanotic nodular lesions, growing to 1 cm or more in diameter. They often remain clinically undiagnosed because of their wide variety of clinical appearances and a lack of pigmentation. Distinguishing a Spitz nevus from a spitzoid melanoma can be extremely difficult. Features that favor the diagnosis of a spitzoid melanoma are asymmetrical shape, diameter greater than 1 cm, a lesion with a deep invasive component, and a high degree of cytologic atypia. There have been only rare reports in the literature of the presence of giant cells in malignant melanoma, and the presence of these cells may result in its misdiagnosis as a histiocytic tumor. We present a case of spitzoid melanoma on the right ankle of a 22-year-old-woman.

Keyword

Giant cells; Spitzoid melanoma

MeSH Terms

Ankle
Diagnosis
Diagnostic Errors
Giant Cells
Melanoma*
Nevus, Epithelioid and Spindle Cell
Pigmentation

Figure

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  Fig. 1 Solitary, relatively ill-defined, 1.5×1 cm-sized erythematous nodule on the right ankle.

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  Fig. 2 (A) Epithelial granuloma-like tumor in the dermis. Atypical mitosis was found predominantly on the deep dermis, but also a little on the superficial dermis. Kamino bodies and pagetoid spread were absent from the epidermal component. The deep dermal invasion pattern of the lower border showed the mixed type, both expansive and infiltrative types (H&E, ×40). (B) The tumor cells were multinucleate and very pleomorphic with abundant cytoplasm and large vesicular nuclei (H&E, ×200). (C) Large vesicular nuclei containing prominent eosinophilic nucleoli (H&E, ×400).

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  Fig. 3 (A) Positive staining reaction for S-100 (×400). (B) Positive staining reaction for Melan-A (×400).

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