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Malignant melanoma is an aggressive, therapy resistant tumor of the skin with increased incidence. Some studies report a better outcome for young patients, while others failed to demonstrate this feature. We present a retrospective study including 28 patients with malignant melanoma aged between 15 and 30 years. Some special morphologic features were identified, sustaining the idea that heterogeneity of malignant melanoma in this age group was very high. In young patients, thin superficial spreading melanomas are more frequent, but there are some patients with very advanced lesions and poor outcome. The high incidence of melanomas developed on preexisting nevi indicates the need for a thorough surveillance of nevi in pediatric patients. [ABSTRACT FROM AUTHOR]

Spitzoid neoplasms are classifi ed as Spitz naevi, atypical Spitz tumours and spitzoid melanomas. In 10-15% of these lesions, anaplastic lymphoma kinase (ALK) fusions were identifi ed, that can be demonstrated by immunohistochemical tests. We report a case of spitzoid melanoma in a 15-year-old female patient. The tumor occurred as an un-ulcerated polypoid pigmented nodule on the left thigh; the histopathologic examination revealed a spitzoid melanoma with Breslow index of 13 mm, with lympho-vascular invasion and immunohistochemical phenotype HMB45+, T311+, Melan A+, p16-, p21+, ALK-; sentinel lymph node biopsy identifi ed three of four positive lymph nodes. The patient is well 20 months after the fi rst diagnosis. Differential diagnosis in spitzoid melanoma is extremely diffi cult, no reliable biomarkers for treatment response prediction or prognosis being available to date. [ABSTRACT FROM AUTHOR]

Spitzoid skin lesions cause diagnosis difficulties due to their clinical, dermoscopicand histopathological similarities to melanomas. A correct diagnosis implies a high expertise and close collaboration between the dermatologistand the pathologist as there are no algorithms or methods of diagnosis with a 100% accuracy. This type of lesions continues to be of interest for scientists considering the fact that 30% of the malpraxis cases of misdiagnosed melanomas are caused by Spitzoid lesions. In most cases, Spitz nevi do not show any chromosomal aberrations and when present they are totally different from those seen in melanomas. In this paper we present two cases of Spitzoid lesions: desmoplastic Spitz nevus and atypical Spitz nevus. The paper underlines the clinical, dermoscopic, histopathological and immunohistochemical features and their impact on final diagnosis. Management of Spitzoid lesions is a challange even for experts. Cytogenetic evaluation of atypical Spitzoid lesions, using comparative genomic hybridization (CGH) and fluorescence in situ hybridization (FISH) respectively, can be very useful when differentiating them from melanomas and establishing their most probable biological behaviour. [ABSTRACT FROM AUTHOR]