Masquerading Spitz naevi on the upper lip: A case report with a brief review of the literature

Abstract

In a scenario where there is an increased incidence of oral squamous cell carcinoma (OSCC) in younger age groups, the diagnosis of pseudo-malignant lesions that mimic the histopathology of a moderate or even high-grade carcinoma becomes imperative for oral pathologists. Though paediatric malignancies such as melanomas and thyroid carcinomas and even OSCCs have been reported in young children, they are rare in the pre-pubertal age group. Melanocytic naevi such as Spitz naevi (SNs) or atypical SNs is, however, more common in this age group and could create some difficulty in diagnosis due to its histological variations that could mimic a malignancy. Hence, the need for a cautious correlation between clinical and histopathological features becomes manifold. Adjunct tools that use diagnostic and molecular techniques such as immunohistochemistry (IHC) and comparative genomic hybridisation (CGH) help in diagnosis and in differentiating certain types of SNs from Spitzoid melanomas or melanomas. A case that histopathologically resembled a moderately differentiated squamous cell carcinoma without any evidence of melanocytic content proved to be a melanocytic naevus after clinical correlation of both age and immunohistochemical analysis. This case report with review brings to light the importance of being aware of such pseudo-malignant lesions in our daily practice.