Multiple Spitz nevi: a clinicopathologic study of 9 patients

Whether agminated, within a speckled lentiginous nevus/nevus spilus, or randomly scattered, multiple Spitz nevi (SN), defined as two or more SN, is a rare entity.

The aim of this study was to evaluate patients presenting with multiple SN.

We conducted a search of the database of the Yale Spitzoid Neoplasm Repository from May 1990 to June 2010 to identify patients with multiple SN. The clinicopathologic features of these patients are the subject of this study.

Nine patients with a total of 38 SN were identified retrospectively during a 20-year period. Patients ranged in age from 2 to 34 years (mean 22 years). The total number of histologically confirmed SN in each patient ranged from 2 to 13 (mean 5; median 2). These SN were more commonly diagnosed clinically as atypical nevi rather than as SN. The histopathologic findings ranged from those of a classic SN to an atypical Spitzoid neoplasm that was difficult to distinguish from a Spitzoid melanoma. Of the SN examined histologically in this series, the majority (53%) showed no atypical histopathologic features and none had recurred after a re-excision.

The low number of patients with multiple SN is a limitation.

The presence of multiple SN is a rare phenomenon. The majority display histopathologic characteristics of classic SN or a few atypical features.