Head currently spinning/trying to understand this.

Glad you are getting expert help.

Spitz nevi are benign and very common in kids.  However, Spitz Nevi look almost identical to melanoma under a microscope.  It is extremely difficult to distinguish between the two lesions – one malignant and one benign.  I do know there is a DNA (FISH test) that can often make the diagnosis more clear.  In the DNA test, a Spitz nevi will have normal DNA but melanoma will have lots of defect.  So if all the experts haven't done the FISH DNA test, I'd request it.

The excision and lymph node biopsy are pretty standard for melanoma.  Even benign lesions can slough cells to the lymph nodes – just so you are aware.  There are some other pediatric individuals on this site.  I would email the MRF asking for any information they have.  Contacts/guidance.  I know they've addressed pediatric melanoma in seminars and research.  Email Tim Turnham (I'm sure there is a link to his email in past posts).  He's the MRF director and can put you in touch with more people/info.

Hang in there and take one day at a time!

Glad you are getting expert help.

Spitz nevi are benign and very common in kids.  However, Spitz Nevi look almost identical to melanoma under a microscope.  It is extremely difficult to distinguish between the two lesions – one malignant and one benign.  I do know there is a DNA (FISH test) that can often make the diagnosis more clear.  In the DNA test, a Spitz nevi will have normal DNA but melanoma will have lots of defect.  So if all the experts haven't done the FISH DNA test, I'd request it.

The excision and lymph node biopsy are pretty standard for melanoma.  Even benign lesions can slough cells to the lymph nodes – just so you are aware.  There are some other pediatric individuals on this site.  I would email the MRF asking for any information they have.  Contacts/guidance.  I know they've addressed pediatric melanoma in seminars and research.  Email Tim Turnham (I'm sure there is a link to his email in past posts).  He's the MRF director and can put you in touch with more people/info.

Hang in there and take one day at a time!

Glad you are getting expert help.

Spitz nevi are benign and very common in kids.  However, Spitz Nevi look almost identical to melanoma under a microscope.  It is extremely difficult to distinguish between the two lesions – one malignant and one benign.  I do know there is a DNA (FISH test) that can often make the diagnosis more clear.  In the DNA test, a Spitz nevi will have normal DNA but melanoma will have lots of defect.  So if all the experts haven't done the FISH DNA test, I'd request it.

The excision and lymph node biopsy are pretty standard for melanoma.  Even benign lesions can slough cells to the lymph nodes – just so you are aware.  There are some other pediatric individuals on this site.  I would email the MRF asking for any information they have.  Contacts/guidance.  I know they've addressed pediatric melanoma in seminars and research.  Email Tim Turnham (I'm sure there is a link to his email in past posts).  He's the MRF director and can put you in touch with more people/info.

Hang in there and take one day at a time!

First of all, let me just say how sorry I am that you have been thrown into such a frightening position. I'm not certain that I can be of much help, but I know that melanoma diagnosis in children is pretty rare. I can understand this causing confusion with pathologists and doctors, who are typically looking for a more common explanation or result. It's very good that there are so many opinions in place, and with some top ranked facilties. I have "cutaneous melanoma", but it is also categorized as "spitzoid". I'd never heard of this, until reading a reseach paper referencing "spitzoid melanoma". A quick search this morning turned up the info below. I was 46 when officially diagnozed with this subtype. Prior to that, I was simply listed as "superficial spreading". However, as you will read below, for patients younger than 20… these skin lesions are more often the benign spitz nevus. Which is likely why so many doctors and pathologists are wanting to confirm absolute diagnosis of your boy's excised skin.

"Spitzoid melanoma is a subtype of melanoma that clinically and histologically resembles a Spitz nevus. Almost all Spitz tumors occur in patients younger than 20-year-old. The older patients, particularly those older than 20 or 30 years old, have a greater likelihood of malignancy. Clinically, spitzoid melanomas are usually changing amelanotic nodular lesions, and can grow to a diameter of 1 cm or more. They often go clinically undiagnosed because of their wide range of clinical appearances and a lack of pigmentation.

Spitz tumors commonly affect the extremities and face, but atypical Spitz tumors may also, less frequently, affect other areas such as the back. They may resemble hemangiomas, pyogenic granulomas, xanthogranulomas, and basal cell carcinomas.

Distinguishing between a Spitz nevus and a spitzoid melanoma can be extremely difficult. Features that support the diagnosis of a spitzoid melanoma are asymmetric shape, diameter greater than 1 cm, a lesion with a deep invasive component, and a high degree of cytologic atypia. "

First of all, let me just say how sorry I am that you have been thrown into such a frightening position. I'm not certain that I can be of much help, but I know that melanoma diagnosis in children is pretty rare. I can understand this causing confusion with pathologists and doctors, who are typically looking for a more common explanation or result. It's very good that there are so many opinions in place, and with some top ranked facilties. I have "cutaneous melanoma", but it is also categorized as "spitzoid". I'd never heard of this, until reading a reseach paper referencing "spitzoid melanoma". A quick search this morning turned up the info below. I was 46 when officially diagnozed with this subtype. Prior to that, I was simply listed as "superficial spreading". However, as you will read below, for patients younger than 20… these skin lesions are more often the benign spitz nevus. Which is likely why so many doctors and pathologists are wanting to confirm absolute diagnosis of your boy's excised skin.

"Spitzoid melanoma is a subtype of melanoma that clinically and histologically resembles a Spitz nevus. Almost all Spitz tumors occur in patients younger than 20-year-old. The older patients, particularly those older than 20 or 30 years old, have a greater likelihood of malignancy. Clinically, spitzoid melanomas are usually changing amelanotic nodular lesions, and can grow to a diameter of 1 cm or more. They often go clinically undiagnosed because of their wide range of clinical appearances and a lack of pigmentation.

Spitz tumors commonly affect the extremities and face, but atypical Spitz tumors may also, less frequently, affect other areas such as the back. They may resemble hemangiomas, pyogenic granulomas, xanthogranulomas, and basal cell carcinomas.

Distinguishing between a Spitz nevus and a spitzoid melanoma can be extremely difficult. Features that support the diagnosis of a spitzoid melanoma are asymmetric shape, diameter greater than 1 cm, a lesion with a deep invasive component, and a high degree of cytologic atypia. "

First of all, let me just say how sorry I am that you have been thrown into such a frightening position. I'm not certain that I can be of much help, but I know that melanoma diagnosis in children is pretty rare. I can understand this causing confusion with pathologists and doctors, who are typically looking for a more common explanation or result. It's very good that there are so many opinions in place, and with some top ranked facilties. I have "cutaneous melanoma", but it is also categorized as "spitzoid". I'd never heard of this, until reading a reseach paper referencing "spitzoid melanoma". A quick search this morning turned up the info below. I was 46 when officially diagnozed with this subtype. Prior to that, I was simply listed as "superficial spreading". However, as you will read below, for patients younger than 20… these skin lesions are more often the benign spitz nevus. Which is likely why so many doctors and pathologists are wanting to confirm absolute diagnosis of your boy's excised skin.

"Spitzoid melanoma is a subtype of melanoma that clinically and histologically resembles a Spitz nevus. Almost all Spitz tumors occur in patients younger than 20-year-old. The older patients, particularly those older than 20 or 30 years old, have a greater likelihood of malignancy. Clinically, spitzoid melanomas are usually changing amelanotic nodular lesions, and can grow to a diameter of 1 cm or more. They often go clinically undiagnosed because of their wide range of clinical appearances and a lack of pigmentation.

Spitz tumors commonly affect the extremities and face, but atypical Spitz tumors may also, less frequently, affect other areas such as the back. They may resemble hemangiomas, pyogenic granulomas, xanthogranulomas, and basal cell carcinomas.

Distinguishing between a Spitz nevus and a spitzoid melanoma can be extremely difficult. Features that support the diagnosis of a spitzoid melanoma are asymmetric shape, diameter greater than 1 cm, a lesion with a deep invasive component, and a high degree of cytologic atypia. "

What horrible news to get at this time of the year. Hugs to you all, this must be really hard for a parent to deal with.

There is a type of benign mole called a spitz naevus – it's uncommon but harmless

http://www.dermnetnz.org/topics/spitz-naevus/

The problem is, it is hard to clinically or microscopically distinguish a spitz naevus from a spitzoid melanoma

http://www.dermnetnz.org/topics/spitzoid-melanoma/

Spitzoid melanomas can be aggressive and can quickly invade deeper tissues.

It may sound odd, but it is a blessing in disguise that this has been found and is being so thoroughly investigated to determine whether it is a benign spitz naevus or a malignant (and potentially aggressive) spitzoid melanoma. Your doctor has hit the panic button but in the case of possible melanoma, this is a very good thing. With melanoma, earlier is also better – no time is a great time but anytime is better than not knowing at all and only finding out when it metastasises to a node or distant organ.

I hope and pray that it turns out to be a spitz naevus after all, and if not that then a spitzoid melanoma caught in it's early stages with a good prognosis. Younger kids like your son fare much better than adults with this type of melanoma, so either way I think your son is in good hands.

Hopes and prayers for you all.

What horrible news to get at this time of the year. Hugs to you all, this must be really hard for a parent to deal with.

There is a type of benign mole called a spitz naevus – it's uncommon but harmless

http://www.dermnetnz.org/topics/spitz-naevus/

The problem is, it is hard to clinically or microscopically distinguish a spitz naevus from a spitzoid melanoma

http://www.dermnetnz.org/topics/spitzoid-melanoma/

Spitzoid melanomas can be aggressive and can quickly invade deeper tissues.

It may sound odd, but it is a blessing in disguise that this has been found and is being so thoroughly investigated to determine whether it is a benign spitz naevus or a malignant (and potentially aggressive) spitzoid melanoma. Your doctor has hit the panic button but in the case of possible melanoma, this is a very good thing. With melanoma, earlier is also better – no time is a great time but anytime is better than not knowing at all and only finding out when it metastasises to a node or distant organ.

I hope and pray that it turns out to be a spitz naevus after all, and if not that then a spitzoid melanoma caught in it's early stages with a good prognosis. Younger kids like your son fare much better than adults with this type of melanoma, so either way I think your son is in good hands.

Hopes and prayers for you all.

What horrible news to get at this time of the year. Hugs to you all, this must be really hard for a parent to deal with.

There is a type of benign mole called a spitz naevus – it's uncommon but harmless

http://www.dermnetnz.org/topics/spitz-naevus/

The problem is, it is hard to clinically or microscopically distinguish a spitz naevus from a spitzoid melanoma

http://www.dermnetnz.org/topics/spitzoid-melanoma/

Spitzoid melanomas can be aggressive and can quickly invade deeper tissues.

It may sound odd, but it is a blessing in disguise that this has been found and is being so thoroughly investigated to determine whether it is a benign spitz naevus or a malignant (and potentially aggressive) spitzoid melanoma. Your doctor has hit the panic button but in the case of possible melanoma, this is a very good thing. With melanoma, earlier is also better – no time is a great time but anytime is better than not knowing at all and only finding out when it metastasises to a node or distant organ.

I hope and pray that it turns out to be a spitz naevus after all, and if not that then a spitzoid melanoma caught in it's early stages with a good prognosis. Younger kids like your son fare much better than adults with this type of melanoma, so either way I think your son is in good hands.

Hopes and prayers for you all.