Case 48 Male, 6 years. Papule, skin of shoulder, since 1½ yearsShow diagnosis & comments
Spitz tumour of uncertain malignant potential (STUMP)
STUMP WITH DEEP NODULAR COMPONENT IN CHILDREN
Some Spitzoid melanocytic proliferations of prepubertal children present with deep, miotitcally active nodules bulging into the deep dermis or even subcutis. Spread to regional lymph nodes is seen repeatedly and to those who regard spread to a regional node as formal proof of malignancy, this means that these lesions are (spitzoid) melanomas. Ohers have pointed out that children with such tumors and nodal deposits do remarkably well, and that distant metastasis appears to be very rare, much rare than one would expect in case of thick melanoma NOS with a positive regional lymh node. For te time being, I therefore regard these lesions as STUMP (Spitz tumor of uncertain malignant potential). Hopefully, future work and clinical experience will shed more light on this issue.
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- Ackerman AB, Mones JM. Rudimentary/elementary. Adv Anat Pathol. 2007 Mar;14(2):143-4; author reply 144-5.