Spitz Nevus

摘要

The putatively benign Spitz nevus was introduced as the "Melanoma of Childhood" in 1948 by Sophie Spitz and is likely the most vexing of melanocytic lesions to the pathologist. Later known by the eponym Spitz nevus, or spindle cell and epithelioid cell nevus, this lesion often simulates malignant melanoma both clinically and histologically. Since its description, controversy has persisted regarding this entity and its benign nature; in fact, metastasizing Spitz nevi have been reported. Although some of these cases may have represented malignant melanoma from the outset, their occurrence heightens the importance of and the difficulty in the distinction between Spitz nevi and melanoma. The gray zone between the benign Spitz nevus and melanoma is often treacherous, especially in recognition of the incompletely understood biology and the haunting reports of regional or widespread lymph node involvement associated with Spitz nevi.