{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T15:29:01Z","timestamp":1788276541194,"version":"build-2803163510"},"reference-count":18,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,5,7]],"date-time":"2026-05-07T00:00:00Z","timestamp":1778112000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,5,7]],"date-time":"2026-05-07T00:00:00Z","timestamp":1778112000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Cutan Pathol"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Spitz tumors represent a heterogeneous group of melanocytic neoplasms ranging from benign Spitz nevi to malignant spitzoid melanoma. Atypical Spitz tumors (ASTs) occupy an intermediate category with uncertain biological potential and pose significant diagnostic challenges, particularly in pediatric patients. We report the case of a 14\u2010year\u2010old girl presenting with a recently changing pigmented lesion on the upper back. Histopathologic examination revealed an asymmetric melanocytic proliferation composed predominantly of epithelioid cells with limited mitotic activity and evidence of dermal maturation. Immunohistochemistry showed diffuse Melan\u2010A and SOX10 positivity, retained p16 expression, a gradient HMB45 staining pattern, and negative PRAME expression. For diagnostic purpose, as a part of diagnosis, next\u2010generation sequencing was performed and identified a RET::MXT1 gene fusion in the absence of additional pathogenic mutations or copy number alterations. To our knowledge, this is the first reported case showing this type of RET fusion. This case highlights the importance of an integrated morphologic, immunophenotypic, and molecular diagnostic approach in atypical spitzoid lesions. Identification of an isolated RET fusion supports classification within the Spitz tumor spectrum and provides valuable information for risk stratification and clinical management in pediatric patients.<\/jats:p>","DOI":"10.1111\/cup.70132","type":"journal-article","created":{"date-parts":[[2026,5,7]],"date-time":"2026-05-07T09:49:50Z","timestamp":1778147390000},"page":"921-924","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Atypical Spitz Tumor With\n                    <scp>RET<\/scp>\n                    ::\n                    <scp>MXT1<\/scp>\n                    Gene Rearrangement in a 14\u2010Year\u2010Old Girl: An Integrated Histopathologic, Immunohistochemical, and Molecular Diagnostic Approach"],"prefix":"10.1111","volume":"53","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-3324-0905","authenticated-orcid":false,"given":"A.","family":"Di Lorito","sequence":"first","affiliation":[{"name":"Pathology Unit, Department of Medical, Oral and Biotechnological Sciences University G. D'Annunzio  Chieti Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Capo","sequence":"additional","affiliation":[{"name":"Clinic of Dermatology, Department of Medicine and Aging Sciences University G. D'Annunzio  Chieti Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L.","family":"Ucci","sequence":"additional","affiliation":[{"name":"Clinic of Dermatology, Department of Medicine and Aging Sciences University G. D'Annunzio  Chieti Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.","family":"Zampacorta","sequence":"additional","affiliation":[{"name":"Pathology Unit SS Annunziata Hospital  Chieti Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F.","family":"Panarese","sequence":"additional","affiliation":[{"name":"Clinic of Dermatology, Department of Medicine and Aging Sciences University G. D'Annunzio  Chieti Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Liberatore","sequence":"additional","affiliation":[{"name":"Pathology Unit SS Annunziata Hospital  Chieti Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L.","family":"Felicioni","sequence":"additional","affiliation":[{"name":"Pathology Unit SS Annunziata Hospital  Chieti Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P.","family":"Amerio","sequence":"additional","affiliation":[{"name":"Clinic of Dermatology, Department of Medicine and Aging Sciences University G. D'Annunzio  Chieti Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,5,7]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1038\/ncomms4116"},{"issue":"6","key":"e_1_2_9_3_1","first-page":"923","article-title":"Genomic Profiling of Spitz Tumors by Array\u2010Based Comparative Genomic Hybridization","volume":"37","author":"Busam K. J.","year":"2013","journal-title":"American Journal of Surgical Pathology"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/PAS.0000000000000387"},{"issue":"2","key":"e_1_2_9_5_1","first-page":"204","article-title":"Atypical Spitz Tumors: Diagnostic Criteria and Clinical Management","volume":"37","author":"Barnhill R. L.","year":"2010","journal-title":"Journal of Cutaneous Pathology"},{"issue":"1","key":"e_1_2_9_6_1","first-page":"1","article-title":"Advances in the Classification of Spitzoid Melanocytic Tumors","volume":"48","author":"Ferrara G.","year":"2021","journal-title":"Journal of Cutaneous Pathology"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.3390\/dermatopathology11010010"},{"issue":"7","key":"e_1_2_9_8_1","first-page":"925","article-title":"ALK Kinase Fusions in Melanocytic Tumors: A Study of Spitzoid Neoplasms","volume":"38","author":"Wiesner T.","year":"2014","journal-title":"American Journal of Surgical Pathology"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jid.2019.12.031"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41379-020-00658-w"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/PAS.0000000000001070"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1136\/jclinpath\u20102020\u2010206991"},{"issue":"6","key":"e_1_2_9_13_1","first-page":"409","article-title":"RET Rearrangements in Spitzoid Melanocytic Neoplasms","volume":"42","author":"Goto K.","year":"2020","journal-title":"American Journal of Dermatopathology"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/DAD.0000000000001780"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.modpat.2025.100740"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrm3190"},{"issue":"10","key":"e_1_2_9_17_1","first-page":"746","article-title":"p16 Expression and Molecular Alterations in Spitz Neoplasms","volume":"46","author":"Raghavan S. 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