ALK-positive compound Spitz nevus with extensive perineural and intraneural neurotropism

J Cutan Pathol. 2021 Jan;48(1):154-159. doi: 10.1111/cup.13890. Epub 2020 Nov 8.

Abstract

Historically recognized by their characteristic histopathologic features, Spitz neoplasms are now known to be molecularly defined by mutually exclusive recurrent abnormalities that cause activation of the MAPK pathway. Spitz neoplasms with ALK rearrangements frequently demonstrate polypoid growth with a plexiform arrangement of nested, fusiform melanocytes in intersecting fascicles. Although neurotropism has been described in indolent Spitz neoplasms, this feature is not frequently mentioned in publications on histopathologic assessment of this group of melanocytic tumors. Here, we present an unusual case of a 3-year-old female with an ALK-positive compound Spitz nevus with extensive perineural and intraneural neurotropism occurring on the vermilion border of the lower lip.

Keywords: ALK; Spitz nevus; neurotropism.

Publication types

  • Case Reports

MeSH terms

  • Anaplastic Lymphoma Kinase / genetics*
  • Child, Preschool
  • Female
  • Humans
  • Lip / pathology
  • Mutation
  • Nevus, Epithelioid and Spindle Cell / genetics
  • Nevus, Epithelioid and Spindle Cell / pathology*
  • Peripheral Nerves / pathology
  • Skin Neoplasms / genetics
  • Skin Neoplasms / pathology*

Substances

  • ALK protein, human
  • Anaplastic Lymphoma Kinase