Incidence and outcome of Spitzoid tumour of unknown malignant potential (STUMP): an analysis of cases in the Netherlands from 1999 to 2014

Ruijter, Claire G. H.; Ouwerkerk, Wouter; Jaspars, Elisabeth H; Doorn, Remco van; Luiten, Rosalie M.; Bekkenk, Marcel W.; Tio, Darryl

doi:10.1111/bjd.19383

Cited by 3 publications

(4 citation statements)

References 8 publications

(13 reference statements)

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“…In general, a very small percentage of AST have been reported to develop into metastases. Only 0.7% of 1237 AST diagnosed in the Netherlands were reported to have developed metastases; a separate study reports one out of 76 AST cases as evolving into a metastatic lesion ( 27 , 179 ). Older age, lesion size >1cm, ulceration, subcutaneous fat involvement, and mitotic activity >6mm 2 are factors that can contribute to the malignant potential of AST ( 181 ).…”

Section: Prognostic and Predictive Featuresmentioning

confidence: 99%

“…The incidences of AST and SM are also unknown, though both tend to be less common than SN ( 18 ). A recent study on the yearly incidence of SN, AST, and SM in the Netherlands between 1999-2014 notably demonstrates the yearly number of SN increasing from 525 cases to 751 cases during this period; AST from 9 to 153 cases; SM from 8 to 40 cases ( 27 ). However, the general increase in incidence as well as the significant increase of AST in this study’s cases may not be due to a real increase but rather may be attributable to better recognition and clinical/histopathological/genetic classification of these lesions ( 27 ).…”

Section: Introductionmentioning

confidence: 97%

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The Spectrum of Spitz Melanocytic Lesions: From Morphologic Diagnosis to Molecular Classification

2022

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Spitz tumors represent a distinct subtype of melanocytic lesions with characteristic histopathologic features, some of which are overlapping with melanoma. More common in the pediatric and younger population, they can be clinically suspected by recognizing specific patterns on dermatoscopic examination, and several subtypes have been described. We now classify these lesions into benign Spitz nevi, intermediate lesions identified as “atypical Spitz tumors” (or Spitz melanocytoma) and malignant Spitz melanoma. More recently a large body of work has uncovered the molecular underpinning of Spitz tumors, including mutations in the HRAS gene and several gene fusions involving several protein kinases. Here we present an overarching view of our current knowledge and understanding of Spitz tumors, detailing clinical, histopathological and molecular features characteristic of these lesions.

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Section: Prognostic and Predictive Featuresmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 97%

The Spectrum of Spitz Melanocytic Lesions: From Morphologic Diagnosis to Molecular Classification

2022

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“…5,6 This group makes up only 2% of all ST, and while most have a positive outcome, there is a small percentage that can result in fatal consequences and distant metastasis. 7,8 However, it remains unclear how to distinguish those with malignant clinical behaviour from the others. Despite all the molecular discoveries that help to understand ST as a distinct group with specific mutagenic driver alterations, histological appearance continues to be the first and often the only useful tool for diagnostic interpretation worldwide.…”

Section: Introductionmentioning

confidence: 99%

“…One of the most challenging categories to identify is the AST 5,6 . This group makes up only 2% of all ST, and while most have a positive outcome, there is a small percentage that can result in fatal consequences and distant metastasis 7,8 . However, it remains unclear how to distinguish those with malignant clinical behaviour from the others.…”

Section: Introductionmentioning

confidence: 99%

Histological interpretation of spitzoid tumours: an extensive machine learning‐based concordance analysis for improving decision making

Mosquera‐Zamudio,

Launet,

Colomer

et al. 2024

Histopathology

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The histopathological classification of melanocytic tumours with spitzoid features remains a challenging task. We confront the complexities involved in the histological classification of these tumours by proposing machine learning (ML) algorithms that objectively categorise the most relevant features in order of importance. The data set comprises 122 tumours (39 benign, 44 atypical and 39 malignant) from four different countries. BRAF and NRAS mutation status was evaluated in 51. Analysis of variance score was performed to rank 22 clinicopathological variables. The Gaussian naive Bayes algorithm achieved in distinguishing Spitz naevus from malignant spitzoid tumours with an accuracy of 0.95 and kappa score of 0.87, utilising the 12 most important variables. For benign versus non‐benign Spitz tumours, the test reached a kappa score of 0.88 using the 13 highest‐scored features. Furthermore, for the atypical Spitz tumours (AST) versus Spitz melanoma comparison, the logistic regression algorithm achieved a kappa value of 0.66 and an accuracy rate of 0.85. When the three categories were compared most AST were classified as melanoma, because of the similarities on histological features between the two groups. Our results show promise in supporting the histological classification of these tumours in clinical practice, and provide valuable insight into the use of ML to improve the accuracy and objectivity of this process while minimising interobserver variability. These proposed algorithms represent a potential solution to the lack of a clear threshold for the Spitz/spitzoid tumour classification, and its high accuracy supports its usefulness as a helpful tool to improve diagnostic decision‐making.

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Ambiguous melanocytic lesions: A retrospective cohort study of incidence and outcome of melanocytic tumor of uncertain malignant potential (MELTUMP) and superficial atypical melanocytic proliferation of uncertain significance (SAMPUS) in the Netherlands

Vermariën-Wang

Doeleman

Doorn

et al. 2023

Journal of the American Academy of Dermatology

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Incidence and outcome of Spitzoid tumour of unknown malignant potential (STUMP): an analysis of cases in the Netherlands from 1999 to 2014

Abstract: 2 Li W, Han J, Choi HK et al. Smoking and risk of incident psoriasis among women and men in the United States: a combined analysis.

Cited by 3 publications

References 8 publications

The Spectrum of Spitz Melanocytic Lesions: From Morphologic Diagnosis to Molecular Classification

The Spectrum of Spitz Melanocytic Lesions: From Morphologic Diagnosis to Molecular Classification

Histological interpretation of spitzoid tumours: an extensive machine learning‐based concordance analysis for improving decision making

Ambiguous melanocytic lesions: A retrospective cohort study of incidence and outcome of melanocytic tumor of uncertain malignant potential (MELTUMP) and superficial atypical melanocytic proliferation of uncertain significance (SAMPUS) in the Netherlands

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