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Spitz tumours are notorious for the difficulty of distinguishing benign neoplasms with atypical features from melanomas and the related diagnostic uncertainty. Advances in the knowledge of the molecular pathways and genomic aberrations associated with these neoplasms have permitted opportunities for a reduction in the number of uncertain diagnoses and a more objective distinction between Spitz tumours from Spitz\u2010like neoplasms. The presence of a Spitz molecular pathway, such as Harvey rat sarcoma viral oncogene homologue (<jats:italic>HRAS<\/jats:italic>) aberrations or kinase fusions, distinguishes a bona fide Spitz neoplasm from Spitz\u2010like naevi or melanomas with conventional driver mutations. Spitz neoplasms with benign histopathological features and, if such testing is performed, benign cytogenetic and molecular findings, are termed Spitz naevi. Spitz neoplasms with frankly malignant histopathological findings or ambiguous microscopic findings associated with genetic or genomic aberrations most in keeping with melanoma are designated as Spitz melanoma. Tumours with microscopic features and genetic\/genomic aberrations in between naevi and melanomas are classified as Spitz melanocytoma.<\/jats:p>","DOI":"10.1111\/his.14583","type":"journal-article","created":{"date-parts":[[2021,12,27]],"date-time":"2021-12-27T18:31:04Z","timestamp":1640629864000},"page":"122-134","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":48,"title":["Spitz melanocytic tumours\u2009\u2013\u2009a review"],"prefix":"10.1111","volume":"80","author":[{"given":"Iwei","family":"Yeh","sequence":"first","affiliation":[{"name":"Department of Dermatology and Pathology University of California San Francisco CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0888-9601","authenticated-orcid":false,"given":"Klaus J","family":"Busam","sequence":"additional","affiliation":[{"name":"Department of Pathology Memorial Sloan Kettering Cancer Center New York NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,12,27]]},"reference":[{"key":"e_1_2_7_2_1","first-page":"591","article-title":"Melanomas of childhood","volume":"24","author":"Spitz S","year":"1948","journal-title":"Am. 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