Paediatric atypical spitzoid melanocytic neoplasm

Cutaneous malignant melanoma is a rare occurrence in children, with an incidence of less than one case per million per year in children under ten years of age. However this statistic is reportedly increasing. Mortality rates in paediatric melanoma are not well described, however reports suggest that 5-year survival rates are improving beyond those of adults. This may be partly attributable to more intensive classification and staging of melanocytic lesions. Atypical spitzoid neoplasms (ASN) are a subcategorisation of the diagnostic spectrum which extends from Spitz naevi to spitzoid melanoma, and are relatively more common than the latter. The clinical and histopathological features of such lesions are imprecise, leading to difficulties in making diagnoses and subsequent management. This report documents one such case arising within an atypical spitzoid melanocytic neoplasm and the clinical process undertaken. In particular we wished to highlight the molecular diagnostics utilised and their impact on the decision-making pathway.