A diagnostic algorithm for atypical spitzoid tumors: guidelines for immunohistochemical and molecular assessment

Cho‐Vega, Jeong Hee

doi:10.1038/modpathol.2016.70

Cited by 29 publications

(33 citation statements)

References 49 publications

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“… 22 , 29 In conjunction with FISH and histological features of atypical Spitz tumors, the application of IHC panels assessing the expression of proteins involved in cell cycle regulation (Ki67, p16) and melanocytic markers (HMB45) can also be helpful in classifying spitzoid lesions. 30 , 31 …”

Section: Pathologymentioning

confidence: 99%

Pediatric melanoma: incidence, treatment, and prognosis

Saiyed¹,

Hamilton²,

Austin

2017

PHMT

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The purpose of this review is to outline recent advancements in diagnosis, treatment, and prevention of pediatric melanoma. Despite the recent decline in incidence, it continues to be the deadliest form of skin cancer in children and adolescents. Pediatric melanoma presents differently from adult melanoma; thus, the traditional asymmetry, border irregularity, color variegation, diameter >6 mm, and evolution (ABCDE) criteria have been modified to include features unique to pediatric melanoma (amelanotic, bleeding/bump, color uniformity, de novo/any diameter, evolution of mole). Surgical and medical management of pediatric melanoma continues to derive guidelines from adult melanoma treatment. However, more drug trials are being conducted to determine the specific impact of drug combinations on pediatric patients. Alongside medical and surgical treatment, prevention is a central component of battling the incidence, as ultraviolet (UV)-related mutations play a central role in the vast majority of pediatric melanoma cases. Aggressive prevention measures targeting sun safety and tanning bed usage have shown positive sun-safety behavior trends, as well as the potential to decrease melanomas that manifest later in life. As research into the field of pediatric melanoma continues to expand, a prevention paradigm needs to continue on a community-wide level.

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Section: Pathologymentioning

confidence: 99%

Pediatric melanoma: incidence, treatment, and prognosis

Saiyed¹,

Hamilton²,

Austin

2017

PHMT

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“…The slide is then examined under a fluorescence microscope and the number of probes in each tumour cell nucleus is counted. A gain of a targeted gene locus is defined as more than two probes per cell in 30 per cent or more of at least 30 counted cells, whereas a loss is fewer than two probes/cell. Probes labelling centromeres are included as controls to detect changes in whole chromosome numbers (aneuploidy).…”

Section: Genomic Applications To the Surgical Management Of Primary Mmentioning

confidence: 99%

“…FISH and aCGH have a 90 per cent concordance rate, with 85 per cent of discrepancies due to inadequate tumour tissue for aCGH. FISH and aCGH can be used as alternative or complementary techniques, and an algorithm has been proposed for their use in atypical Spitz tumours.…”

Section: Genomic Applications To the Surgical Management Of Primary Mmentioning

confidence: 99%

Impact of genomics on the surgical management of melanoma

Ferguson

Long

Scolyer

et al. 2018

British Journal of Surgery

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Background: Although surgery for early-stage melanoma offers the best chance of cure, recent advances in molecular medicine have revolutionized the management of late-stage melanoma, leading to significant improvements in clinical outcomes. Research into the genomic drivers of disease and cancer immunology has not only ushered in a new era of targeted and immune-based therapies for patients with metastatic melanoma, but has also provided new tools for monitoring disease recurrence and selecting therapeutic strategies. These advances present new opportunities and challenges to the surgeon treating patients with melanoma. Methods:The literature was reviewed to evaluate diagnostic and therapeutic advances in the management of cutaneous melanoma, and to highlight the impact of these advances on surgical decision-making.Results: Genomic testing is not required in the surgical management of primary melanoma, although it can provide useful information in some situations. Circulating nucleic acids from melanoma cells can be detected in peripheral blood to predict disease recurrence before it manifests clinically, but validation is required before routine clinical application. BRAF mutation testing is the standard of care for all patients with advanced disease to guide therapy, including the planning of surgery in adjuvant and neoadjuvant settings.Conclusion: Surgery remains central for managing primary melanoma, and is an important element of integrated multidisciplinary care in advanced disease, particularly for patients with resectable metastases. The field will undergo further change as clinical trials address the relationships between surgery, radiotherapy and systemic therapy for patients with high-risk, early-stage and advanced melanoma.

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“…Although imperfect, p16 immunohistochemical staining is commonly used in the evaluation of spitzoid melanocytic lesions . p16 protein is encoded by the cyclin‐dependent kinase inhibitor 2A ( CDKN2A ) gene located on chromosome 9p21 and functions as a tumor suppressor by inhibiting the CDK4/cyclin D complex at the G1/S cell cycle checkpoint .…”

Section: Introductionmentioning

confidence: 99%

“…10,12 An intermediate category of spitzoid lesion, "atypical Spitz tumors", show histological features of classic Spitz nevi with one or more of the concerning histopathologic features of spitzoid melanomas. 1,2,[12][13][14] Atypical Spitz tumors (ASTs) have a fairly high incidence of sentinel lymph node positivity, estimated to be approximately 39% aggregating data from several studies, although the rate of distant metastasis seems to be low and the overall prognosis appears to be better than for patients with unambiguous melanomas. 15,16 Immunohistochemical stains are frequently used to help differentiate spitzoid melanocytic lesions but all are imperfect discriminators.…”

Section: Introductionmentioning

confidence: 99%

Expression of p15 in a spectrum of spitzoid melanocytic neoplasms

et al. 2019

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Background Accurate classification of spitzoid melanocytic lesions is difficult due to overlapping clinical and histopathologic features between Spitz nevi, atypical Spitz tumors (ASTs), and spitzoid melanomas. Expression of p16 (CDKN2A) has been used as a marker of spitzoid lesions. However, its expression may be variable. p15 is a tumor suppressor encoded by CDKN2B, loss of which has been recently shown to promote transition from nevus to melanoma. We sought to determine whether p15 is a useful immunohistochemical marker to distinguish Spitz nevi from spitzoid melanomas and to compare p15 and p16 staining in this population. Methods Immunohistochemistry for p15 and p16 was performed on Spitz nevi (n = 19), ASTs (n = 41), and spitzoid melanomas (n = 17). Immunoexpression was categorized by a four‐tiered system: 0 (negative), 1+ (weak), 2+ (moderate), 3+ (strong). Results 3+/strong p15 staining was observed in 68.4% of Spitz nevi, 34.2% of ASTs, and 17.7% of spitzoid melanomas. By contrast, we observed 3+ p16 staining in roughly equivalent percentages of Spitz nevi (57.9%), ASTs (56.1%), and spitzoid melanomas (58.8%). Conclusion These data illustrate that p15 may be more useful than p16 as a biomarker to help distinguish benign from malignant spitzoid lesions.

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A diagnostic algorithm for atypical spitzoid tumors: guidelines for immunohistochemical and molecular assessment

Cited by 29 publications

References 49 publications

Pediatric melanoma: incidence, treatment, and prognosis

Pediatric melanoma: incidence, treatment, and prognosis

Impact of genomics on the surgical management of melanoma

Expression of p15 in a spectrum of spitzoid melanocytic neoplasms

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