An atypical Spitz tumor can be difficult to distinguish from a malignant melanoma. A grading system can be used to separate Spitz tumors in children according to their risk for metastasis.
Patient selection:
• 30 patients with atypical Spitz tumors
• The patients were children and adolescents < 18 years of age.
Parameters used for grading:
(1) age of the patient in years
(2) diameter of the lesion in millimeters
(3) involvement of fat
(4) ulceration of the lesion
(5) mitotic activity
|
Parameter |
Finding |
Points |
|
age in years |
0 to 10 |
0 |
|
|
11 to 17 |
1 |
|
diameter of lesion in mm |
<= 10 mm |
0 |
|
|
> 10 mm |
1 |
|
involvement of fat |
absent |
0 |
|
|
present (Clark Level V) |
2 |
|
ulceration of lesion |
absent |
0 |
|
|
present |
2 |
|
mitotic activity per square mm |
<= 5 |
0 |
|
|
6 - 8 |
2 |
|
|
> 8 |
5 |
score =
= SUM(points for the 5 parameters)
Interpretation:
• minimum score: 0
• maximum score: 11
|
Score |
Risk Group |
Patients with Metastases in Study Group |
|
0 - 2 |
low |
1 of 14 (7%) |
|
3 - 4 |
intermediate |
3 of 6 (50%) |
|
5 - 11 |
high |
7 of 9 (78%) |
Specialty: Hematology Oncology, Surgery, general, Dermatology
ICD-10: ,
