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Atypical Spitzoid neoplasms: a review of potential markers of biological behavior including sentinel node biopsy

McCormack, Christopher J.a; Conyers, Rachel K.d; Scolyer, Richard A.e; Kirkwood, Johnf; Speakman, Davida; Wong, Nickc; Kelly, John W.b; Henderson, Michael A.a

doi: 10.1097/CMR.0000000000000084
Review Articles

Atypical cutaneous melanocytic lesions, including those with Spitzoid features, can be difficult to categorize as benign or malignant. This can lead to suboptimal management, with potential adverse patient outcomes. Recent studies have enhanced knowledge of the molecular and genetic biology of these lesions and, combined with clinicopathological findings, is further defining their biological spectrum, classification, and behavior. Sentinel node biopsy provides important prognostic information in patients with cutaneous melanoma, but its role in the management of melanocytic lesions of uncertain malignant potential (MELTUMP) is controversial. This paper examines the role of molecular testing and sentinel node biopsy in MELTUMPs, particularly atypical Spitzoid tumors.

aPeter Macallum Cancer Institute, East Melbourne

bVictorian Melanoma Service, Alfred Hospital, Prahran

cDepartment of Paediatrics, Murdoch Children’s Research Institute, Royal Children’s Hospital, The University of Melbourne, Parkville

dThe Royal Children’s Hospital, Flemington Road, Parkville, Victoria

eMelanoma Institute Australia , Royal Prince Alfred Hospital, The University of Sydney, Sydney, New South Wales, Australia

fDepartment of Medicine, Melanoma and Skin Cancer Program, University of Pittsburgh Cancer Institute, Pittsburgh, Pennsylvania, USA

Present address: Nick Wong, Ludwig Cancer Research, Olivia Newton John Cancer and Wellness Centre, Austin Hospital, Heidelberg, Victoria 3084, Australia

Correspondence to Christopher McCormack, MBBS, FACD, Surgical Oncology, Peter Macallum Cancer Institute, St Andrews Place, East Melbourne, VIC 3002, Australia Tel: +61 395324291; fax: +61 39532 4354; e-mail:

Received December 8, 2013

Accepted February 12, 2014

© 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins