› Forums › General Melanoma Community › Are my path reports through enough?
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tangokilo.
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- September 28, 2015 at 4:09 pm
Hi I am a 29 year old male, this past May I had a mole removed by shave biopsy and was diagnosed with Melanoma In Situ. Looking at my path reports from the shave biopsy and the excision it seems they do not include very much detail. I was courious of the actual depth/thickness of the melanoma and type (superficial spreading, lentigo maligna, etc.) both of which are not on the path reports.
Below I have typed all of the information listed on each pathology report, should there not be more information on theses? Also any help deciphering what they mean?
05-28-15 Clinical info (Shave, Irregular brown papule, R/O dysplastic nevus)
Gross Description: Specimen received in formalin identified as "left anterior distal thigh" and consist of a tissue fragment measuring 9 x 5 mm. The specimen is trisected and totally submitted in one cassette.
Microscopic Description: The epidermis shows a broad confluent proliferation of mostly solitary, junctional, atypical melanocytes. MART-1 immunostain highlights these features. Controlstains appropriately.
Diagnosis: Skin, Left anterior distal thigh- Melanoma In Situ.
06-08-15 Clinical info (Excision, malignant melanoma in situ, please check margins)
Gross Description: Specimen received in formalin identified as "left Anterior Distal Thigh" and consists of a tan excision measuring 38 x 15 x 7 mm. The specimen is serially sectioned and totally submitted in six cassettes (A1=2 pcs., A2=2pcs., A3=2pcs., A4=2pcs., A5=2 pcs., A6=3pcs.)
Microscopic Description: Sections display epidermal ulceration with underlying granulomatous inflammation and early scar formation. Horizontally oriented dermal fibrosis is associated with increased capillaries and a sparse inflammatory infiltrate.
Diagnosis: Skin, Left anterior distal thigh- Biopsy site reaction. Note: There is no evidense of residual melanoma in situ. Deep and peripheral margins are free of malignancy.
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- September 28, 2015 at 10:03 pm
Depth isn't given in MIS, it is only given for invasive melanoma. As far as detail in a path report, this actually has quite a bit. For the most part it doesn't really matter though– what matters is that it was in situ so it cannot spread, and your margins were likely clear so you can go ahead and close the book on this matter. Only thing to worry about now is to remain vigilant for other primaries in the future.
I say this as a fellow in situ patient. I spent many months obsessing over it until I realized there is really nothing to obsess over besides future surveillance.
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- September 28, 2015 at 10:03 pm
Depth isn't given in MIS, it is only given for invasive melanoma. As far as detail in a path report, this actually has quite a bit. For the most part it doesn't really matter though– what matters is that it was in situ so it cannot spread, and your margins were likely clear so you can go ahead and close the book on this matter. Only thing to worry about now is to remain vigilant for other primaries in the future.
I say this as a fellow in situ patient. I spent many months obsessing over it until I realized there is really nothing to obsess over besides future surveillance.
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- September 28, 2015 at 10:03 pm
Depth isn't given in MIS, it is only given for invasive melanoma. As far as detail in a path report, this actually has quite a bit. For the most part it doesn't really matter though– what matters is that it was in situ so it cannot spread, and your margins were likely clear so you can go ahead and close the book on this matter. Only thing to worry about now is to remain vigilant for other primaries in the future.
I say this as a fellow in situ patient. I spent many months obsessing over it until I realized there is really nothing to obsess over besides future surveillance.
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- September 29, 2015 at 3:05 am
Yes, for in situ this is pretty much all you get on a path report. Because in situ melanoma has no metastatic potential, not much detail is required. Once a melanoma is invasive you get a much longer report. Source: my first melanoma was in situ. Subsequent two were invasive (thankfully very thin). In situ path report was four lines long, invasive 1 page long. BTW I probably had all three mels at once, there was just a few months between removal / WLE of all three. Have you had a super-thorough skin check to make sure this is your only primary mel? It can happen that you have more at the same time (or, at some point in future another one develops). I'm on three-monthly skin checks now.
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- September 29, 2015 at 9:06 pm
Glad to know that my report is consistent.
I have been check by a dermatologist when the biopsy occurred then after the excision I saw an oncologist who gave me a through check. I also just had my first 3mo. apt with a full check where I opted to have another mole removed that appeared around 2012 and has grown about 1.5X, but it has no visual signs of melanoma. I was glad to have it removed but…. The Dr. was about to do a shave biopsy on it, and I questioned him about that asked if a punch would be better incase it were melanoma to stage it better. He did the punch biopsy however the mole was larger than the punch size so I still have some edges of the mole left. I feel like he should have did a small excision to completely removed it not just part.
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- September 29, 2015 at 9:06 pm
Glad to know that my report is consistent.
I have been check by a dermatologist when the biopsy occurred then after the excision I saw an oncologist who gave me a through check. I also just had my first 3mo. apt with a full check where I opted to have another mole removed that appeared around 2012 and has grown about 1.5X, but it has no visual signs of melanoma. I was glad to have it removed but…. The Dr. was about to do a shave biopsy on it, and I questioned him about that asked if a punch would be better incase it were melanoma to stage it better. He did the punch biopsy however the mole was larger than the punch size so I still have some edges of the mole left. I feel like he should have did a small excision to completely removed it not just part.
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- September 29, 2015 at 9:06 pm
Glad to know that my report is consistent.
I have been check by a dermatologist when the biopsy occurred then after the excision I saw an oncologist who gave me a through check. I also just had my first 3mo. apt with a full check where I opted to have another mole removed that appeared around 2012 and has grown about 1.5X, but it has no visual signs of melanoma. I was glad to have it removed but…. The Dr. was about to do a shave biopsy on it, and I questioned him about that asked if a punch would be better incase it were melanoma to stage it better. He did the punch biopsy however the mole was larger than the punch size so I still have some edges of the mole left. I feel like he should have did a small excision to completely removed it not just part.
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- September 29, 2015 at 3:05 am
Yes, for in situ this is pretty much all you get on a path report. Because in situ melanoma has no metastatic potential, not much detail is required. Once a melanoma is invasive you get a much longer report. Source: my first melanoma was in situ. Subsequent two were invasive (thankfully very thin). In situ path report was four lines long, invasive 1 page long. BTW I probably had all three mels at once, there was just a few months between removal / WLE of all three. Have you had a super-thorough skin check to make sure this is your only primary mel? It can happen that you have more at the same time (or, at some point in future another one develops). I'm on three-monthly skin checks now.
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- September 29, 2015 at 3:05 am
Yes, for in situ this is pretty much all you get on a path report. Because in situ melanoma has no metastatic potential, not much detail is required. Once a melanoma is invasive you get a much longer report. Source: my first melanoma was in situ. Subsequent two were invasive (thankfully very thin). In situ path report was four lines long, invasive 1 page long. BTW I probably had all three mels at once, there was just a few months between removal / WLE of all three. Have you had a super-thorough skin check to make sure this is your only primary mel? It can happen that you have more at the same time (or, at some point in future another one develops). I'm on three-monthly skin checks now.
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Tagged: cutaneous melanoma
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