“Red Spitz Tumor” on the Ear: Case Report and Review of the Literature

Abstract

Spitz nevus (SN) is a benign melanocytic lesion with cytologic and architectural atypia. It is sometimes difficult to distinguish SNs from atypical Spitz tumor (AST), Spitz melanoma, or conventional melanoma. SNs frequently develop in Caucasians and appear on the skin of the head and lower extremities. Lesions on the ear in Asian populations are rare. Here, we report a "red Spitz tumor" on the ear of a Chinese 18year-old boy. Dermoscopic examination revealed possibly malignant features presented as polymorphous vessels along with central white area, pseudo-network depigmentation and atypical peripheral globular pattern. The results of histopathological examination strongly suggested that the neoplasm was a compound SN and no recurrences or metastases occurred during 1-year follow-up post-surgery. Further, we review the literature on 4 previously reported cases of SN on the ear and summarize the main points of SN diagnosis and differential diagnosis with atypical Spitz tumors and melanoma.

Pediatric spitzoid lesions of the ear: a single center experience and review of literature

“…Moreover, 0% of identified ear ASTs had multiple dermatoscopical irregularities, which is in line with the general trend of the literature, where almost 20% of ASTs of the whole body are reported to have only typically benign features. 7 It is worth noting that dermatoscopical irregularities were not significantly associated with AST, neither in our series nor in the reviewed literature (respectively p=0.375 and p=0.3333), supporting the fact that relying only on the dermatoscopical aspect of spitzoid lesions is not accurate enough for the special site of the ear and that dermatoscopy could actually be misleading.…”

“…Throughout the systematic research of the literature, a total of 2105 articles were initially retrieved, but, finally, only 4 articles describing 9 patients satisfied the strict inclusion criteria and were selected, as presented in Table 2. 4,[6][7][8] A schematic illustration of the literature search and the study selection criteria is presented in Figure 2.…”

“…Moreover, 0% of identified ear ASTs had multiple dermatoscopical irregularities, which is in line with the general trend of the literature, where almost 20% of ASTs of the whole body are reported to have only typically benign features. 7 …”

“…We included studies and reviews reporting new cases of spitzoid lesions of the ear in pediatric age (≤18 years), dermatoscopically and clinically evaluated, and histopathologically confirmed (Table 2). 4,[6][7][8]…”