Metastatic Spitzoid Melanoma in a Child: Case Report

Abstract

Spitzoid melanoma is an extremely rare and aggressive melanocytic neoplasm in childhood, and is clinically and histopathologically difficult to differentiate from other Spitzoid lesions. We present the case of a 6-year-old girl diagnosed with BRAF V600E-mutated infantile Spitzoid melanoma, metastatic to regional lymph nodes. The patient was treated with pembrolizumab (anti-PD-1) and local cryosurgery for palliative purposes, with a good initial partial response. Subsequent disease progression prompted the indication of salvage targeted therapy. She remains under multidisciplinary follow-up, has well tolerated treatment, and has not experienced visceral progression to date.This case underscores the diagnostic complexity of Spitzoid melanocytic tumors in childhood and highlights the importance of integrating histological and molecular data to guide therapeutic decisions.