I don’t feel like I can find good information regarding spitz nevi anywhere so I’m reaching out to get opinions on my pathology report. Shortly after my pregnancy in Jan 2020, I noticed a round, raised pink bump with corkscrew vessels on my left upper abdomen. The first dermatologist I saw believe it was just a hemangioma related to hormone changes. I insisted she remove it and she performed a shave biopsy and sent it to the lab. Their report is below….
Specimen received in formalin, consists of rubbery tan tissue measuring 3x3x1mm.
Spitzoid melanocytic lesion, favor spitz nevus (spindle and epitheloid cell nevus) compound type, margins involved. Further surgical excision advised.
Post excision-scar, no residual nevus seen.
I was DISTURBED by the lack on information in this first pathology report so I switched dermatologists and sent the specimen to a second lab. Their report is below.
Left upper medial abdomen shows a compound melanocytic proliferation with a rather circumscribed silhouette; although one edge of the lesion abuts the peripheral border. It consists of medium-sized epithelioid melanocytes in nested pattern at the dermoepidermal junction and papillary dermis focally breaking into single cell units centrally within the lesion. Variably sized junctional melanocytic nests are associated with hyperplastic epidermis and are focally separated by cleft spaces. This is a patchy sparse lymphocytic infiltrate along the lower border of the lesion. Few mitosis are noted in junctional melanocytic nests with one mitosis seen in the dermal component near the base of the lesion.
The findings show a compound epithelioid melanocytic proliferation with features of a spitz nevus and atypia.
The excision of the above lesion shows no residual melanocytic proliferation.
My new dermatologist says I am very high risk for melanoma. I have since had three moles removed, two that were mildly atypical and one that was moderate so I again had a complete excision. Should I seek a third opinion or go to a melanoma specialist? What about a SLN biopsy? What is the difference between a melanoma specialist and a general dermatologist? Sorry for all the question but I’ve had a cloud hanging over my head since June and had to wait almost a month to get this new pathology report….I was hoping for more specifics like degree of atypia etc.
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