BACKGROUNDAlthough the majority of melanomas demonstrate high rates of mutations in B‐RAF or N‐RAS that result in constitutive activation of the mitogen‐activated protein kinase‐signaling pathway, emerging data suggest molecular differences among melanoma subtypes. In this study, the authors evaluated the contribution of B‐RAF and N‐RAS mutations to the pathogenesis of Spitzoid melanomas.METHODSIn total, 33 Spitzoid melanomas were analyzed for clinical and pathologic characteristics as well as for hot‐spot mutations in the B‐RAF and N‐RAS genes. In the majority of patients (28 of 33 melanomas), the tumors were confined to the skin with no evidence of metastasis (average follow‐up, 32.5 mos). There were five metastasizing melanomas (5 of 33 tumors) with regional or systemic spread.RESULTSOf 33 Spitzoid melanomas, only 1 showed the V600E mutation in the B‐RAF gene (1 of 33 tumors; 3%). It was noteworthy that none of the metastatic Spitzoid melanomas (0 of 5 tumors; 0%), of which 2 resulted in fatal outcomes, demonstrated mutations in B‐RAF or N‐RAS.CONCLUSIONSIn contrast to the majority of cutaneous melanomas, activating hot‐spot mutations in B‐RAF or N‐RAS were not involved in the pathogenesis of Spitzoid melanoma. These data suggested that Spitzoid melanoma is a distinct form of melanoma with unknown genes and/or signaling pathways involved in its development. Cancer 2006. © 2006 American Cancer Society.