Outcomes of atypical spitz tumors with chromosomal copy number aberrations and conventional melanomas in children

Pedram Gerami*, Chelsea Cooper, Shirin Bajaj, Annette Wagner, Douglas Fullen, Klaus Busam, Richard A. Scolyer, Xiaowei Xu, David E. Elder, Ronnie M. Abraham, Victor G. Prieto, Joan Guitart, Ping Liu, Ekaterina Pestova, Raymond L. Barnhill

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

73 Scopus citations


Death due to melanoma in childhood (up to 20 y of age) is a rare event, with an average of 18 cases reported annually in the United States. In this study we evaluated 2 subgroups of high-risk melanocytic neoplasms in childhood, specifically atypical Spitz tumors (ASTs) with chromosomal copy number changes and conventional melanomas. We analyzed the clinical, histologic, and molecular features of all cases and performed the Fisher exact test, logistic regression, and multivariate analysis to evaluate features associated with aggressive clinical behavior in these cases. Among the ASTs, all of which had 1 or more chromosomal copy number aberrations, the presence of homozygous 9p21 deletions and a positive sentinel lymph node were each found to be correlated with tumor extension beyond the sentinel lymph node, with P-values of 0.046 and 0.01, respectively. Two patients with ASTs that had homozygous 9p21 deletions developed brain metastasis, one of whom died of disease. Among the 21 conventional melanomas, 3 patients developed distant metastasis and died of disease. Chromosomal copy number aberrations evaluated by fluorescence in situ hybridization were present in the majority of the cases (16/18). Among conventional melanomas, we did not identify any clinical, histologic, or molecular features associated with aggressive behavior. The presence of 8q24 gains was seen almost exclusively in 6 amelanotic small cell melanomas in children of whom 1 died of disease. Characteristic chromosomal copy number aberrations may occur in specific subtypes of melanocytic neoplasms in children and may help with the classification and prognostication of these rare tumors.

Original languageEnglish (US)
Pages (from-to)1387-1394
Number of pages8
JournalAmerican Journal of Surgical Pathology
Issue number9
StatePublished - Sep 2013


  • Atypical Spitz tumors
  • Melanoma
  • Pediatric melanoma
  • Spitz nevi
  • Spitzoid melanoma

ASJC Scopus subject areas

  • Anatomy
  • Surgery
  • Pathology and Forensic Medicine


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