Review ArticlesSentinel Lymph Node Biopsy for Patients With Diagnostically Controversial Spitzoid Melanocytic Tumors?Busam, Klaus J. MD; Pulitzer, Melissa MDAuthor Information Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York, NY Reprints: Klaus J. Busam, MD, Department of Pathology, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, Box 32, New York, NY 10065 (e-mail: [email protected]). Advances in Anatomic Pathology: September 2008 - Volume 15 - Issue 5 - p 253-262 doi: 10.1097/PAP.0b013e31818323ac Buy Metrics Abstract The distinction of a Spitz nevus from melanoma can be very difficult. Pathologists may disagree on whether a Spitzoid melanocytic proliferation is benign or malignant, or acknowledge uncertainty about the diagnosis. As long as melanoma is suspected or strongly considered, a clinical management plan is often adopted as if the patient had melanoma, which may include sentinel lymph node (SLN) biopsy for staging. The findings of the sentinel node may resolve the diagnostic controversy about the primary tumor, but there is also the risk for more diagnostic confusion, uncertainty, and errors. We review the arguments in favor and against SLN biopsy for patients with diagnostically controversial Spitzoid melanocytic tumors, summarize current experience, and illustrate diagnostic pitfalls. Although SLN biopsy provides prognostic information helpful for clinical trials, we caution against performing the procedure as a diagnostic adjunct. © 2008 Lippincott Williams & Wilkins, Inc.