Low Lethal Potential for Atypical Spitz Tumors

ASTs have favorable prognosis, elevated melanoma risk, moderate risk of regional nodes mets

THURSDAY, Oct. 20 (HealthDay News) -- Atypical Spitz tumors (ASTs) are associated with a favorable prognosis, an increased melanoma risk, and a moderate risk of metastasis to regional nodes, according to a study published in the October issue of the Archives of Dermatology.

Alireza Sepehr, M.D., from Harvard Medical School in Boston, and colleagues investigated the clinical outcomes of classic Spitz nevi, atypical ASTs, and spitzoid melanomas. Data from 1997 to 2002 were collected from the pathology database at Massachusetts General Hospital and 157 patients with Spitz-type melanocytic lesions were followed up. Outcomes included sentinel lymph node biopsy results, metastases, or fatality.

The investigators identified 68 classic Spitz nevi, 76 ASTs, 10 spitzoid melanomas, and three melanomas that arose in Spitz nevi. Diagnosis of Spitz nevi occurred in patients at a significantly younger age than ASTs (mean age, 26.4 years versus 33.7 years), and both occurred significantly earlier than melanomas (mean age, 50.4 years). Positive sentinel lymph node biopsy findings were found in one of six patients with ASTs and four of eight patients with spitzoid melanomas. Distant metastasis developed in only one patient with an AST, who had a separate intermediate-thickness melanoma. Among 144 patients with classic Spitz nevi or ASTs, there were six documented invasive melanomas.

"Our study suggests that ASTs are associated with low lethal potential, an increased melanoma risk, and a metastatic capability to regional nodes," the authors write.

One of the study authors disclosed financial ties to MELA Sciences, which produces a device for detecting melanoma.

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