Case 10 Male, 34 years. Papule, skin near corner of eyeShow diagnosis & comments
(Spitzoid spindle-cell amelanotic) nodular melanoma
Superficial parts of the lesion resemble Spitz naevus, but deeper parts reveal the true nature of the lesion, featuring a bulky, abnormally compact architecture and considerable mitotic activity.
Such melanomas may be easily missed when a superficial shave biopsy, not containing the deep part of the lesion, is submitted. For this reason, it is better not to render an unequivocal diagnosis of Spitz naevus on the basis of a superifical shave biopsy unaccompanied by detailed clinical information; in such instances, a completion excsional biopsy including the basal component of the lesion should be requested, in order not to miss a melanoma such as this one.