[Spitz tumors]

Spitz tumors constitute a group of melanocytic neoplasms that can still pose a diagnostic challenge in individual cases.

This article provides an overview of the current classification of Spitz tumors with a focus on histopathological aspects.

The Spitz nevus and its variants, the atypical Spitz tumor/Spitz melanocytoma, and the Spitz melanoma were examined.

With the increasing availability of information from histomorphology, immunohistochemistry, and, most recently, molecular pathology, the classification and associated terminology have changed in recent years.

While pathologists largely agree on the diagnosis of small and "classic" cases of Spitz nevi in children or adolescents, there can be significant differences among pathologists regarding whether a lesion is assessed as benign or malignant in less typical cases. For more complex tumors, immunohistochemical and molecular characteristics provide support, both in distinguishing them from other types of nevi and as an essential basis for the classification of Spitz tumors themselves. Spitz melanoma is considered an intermediate stage in the progression of Spitz tumors. However, there remains a subset of Spitz tumors in which even experienced experts are unable to make a definitive morphological distinction between a nevus and a melanoma.