Atypical Spitz Tumor in a Pediatric Patient: A Case Report and Review of the Literature

Spitzoid neoplasms are a collection of melanocytic lesions distinguished from conventional nevi or melanoma by a unique set of histological and molecular features. These Spitzoid proliferations - Spitz nevus, atypical Spitz tumor (AST), and Spitzoid melanoma - range from benign to malignant. Morphology alone has been an insufficient prognostic tool, but immunohistochemical stains prove useful for risk stratification. ASTs rarely metastasize beyond regional lymph nodes, and treatment includes wide local excision with or without sentinel lymph node biopsy depending on histomolecular features. Wide local excision of ASTs with negative margins is typically curative, with excellent long-term survival in pediatric cases. We present a case that highlights the importance of morphologic and molecular analysis to assess risk and guide management. Further research into molecular biomarkers may improve risk stratification and optimize treatment strategies for atypical Spitz tumors in pediatric patients.