› Forums › Cutaneous Melanoma Community › Can Skin-to-Skin Metastasis Happen Without Lymph or Blood Involvement?
- This topic has 12 replies, 3 voices, and was last updated 9 years, 6 months ago by
Janner.
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- October 13, 2014 at 1:08 am
If a path report says "metastatic melanoma" and they haven't found the primary — and assumption is that primary is/was also in skin — does this mean that the cancer spread from skin site one-to-lymph- system- to skin site two? Or can melanoma metastisize from one skin site to another with no lymph or blood involvement? And if so, does this make the metastasis any less threatening or easier to treat? Or is it not metastasis if no blood or lymph node involvement? Hope this makes sense.
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- October 13, 2014 at 4:33 am
To go from one place on the skin to another, it travels through the lymph vessels. The path report mentions vessel involvement if I remember correctly. Blood vessels less likely as mets to organs are most likely then. When it travels thru the lymph vessels, it doesn't mean it has hit the lymph nodes yet, but that would be the most likely next stop. This type of spread would be called in-transit as long as it is within the same lymph basin as the primary. You get to make assumptions since you don't know for sure where the primary might have been. You can also look for sub-q's (subcutaneous mets) here and find other related posts.
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- October 13, 2014 at 12:17 pm
Janner: Thank you, as always. It occurred to me that I didn't know whether lymph was involved in skin-to-skin metastasis, and on "Update" (excellent information, some of which I paid for with a 30-day subscription) I found material re: satellite metastases and in-transit metastasis. Thank goodness, BIL will have SLNB and WLE tomorrow morning, and then we'll know more. "Update" describes BIL's scenario as "clinical stage III" even if no node involvment found.
*Are they able to tell patient the same day whether cancer found in any nodes, or does it take days?
*Can they easily identify in-transit metastases by looking at WLE tissue?
*Is the surgeon (a general surgeon at a local hospital) likely to ask BIL if he has an oncologist, or to refer him to one/tell him that this is the next step? I'm hoping this is major component of proceedings….even hoping that maybe surgeon might mention Hopkins as option.
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- October 13, 2014 at 1:07 pm
My initial surgery also was done locally and doctors here did the initial diagnosis. Slides were then sent to Hopkins for further evaluation and they confirmed the diagnosis. I think about a week to 10 days elapsed before we got the confirming results. At that point my local surgeon turned me over to Hopkins for care. Hopkins was excellent about getting back to me with scheduling an appointment with one of their dermatologists. I suspect your BIL may have a similar route.
I think that seeing the dermatologist first had more to do with my unknown primary than anything else. The plan was for him to give me a thorough skin exam and to remove anything that even remotely looked suspicious (he found nothing, BTW). He also provided me with information on what the next steps for me were.
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- October 13, 2014 at 1:07 pm
My initial surgery also was done locally and doctors here did the initial diagnosis. Slides were then sent to Hopkins for further evaluation and they confirmed the diagnosis. I think about a week to 10 days elapsed before we got the confirming results. At that point my local surgeon turned me over to Hopkins for care. Hopkins was excellent about getting back to me with scheduling an appointment with one of their dermatologists. I suspect your BIL may have a similar route.
I think that seeing the dermatologist first had more to do with my unknown primary than anything else. The plan was for him to give me a thorough skin exam and to remove anything that even remotely looked suspicious (he found nothing, BTW). He also provided me with information on what the next steps for me were.
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- October 13, 2014 at 1:07 pm
My initial surgery also was done locally and doctors here did the initial diagnosis. Slides were then sent to Hopkins for further evaluation and they confirmed the diagnosis. I think about a week to 10 days elapsed before we got the confirming results. At that point my local surgeon turned me over to Hopkins for care. Hopkins was excellent about getting back to me with scheduling an appointment with one of their dermatologists. I suspect your BIL may have a similar route.
I think that seeing the dermatologist first had more to do with my unknown primary than anything else. The plan was for him to give me a thorough skin exam and to remove anything that even remotely looked suspicious (he found nothing, BTW). He also provided me with information on what the next steps for me were.
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- October 13, 2014 at 2:18 pm
*Are they able to tell patient the same day whether cancer found in any nodes, or does it take days? Days. They process in paraffin and stain the tissue to more easily identify melanocytes. Just like is done in biopsies.
*Can they easily identify in-transit metastases by looking at WLE tissue? Maybe if there are other in-transit tumors nearby, but it may not indicate if cells just moved thru the vessels to go outside the WLE tissue.
You can only hope about the oncologist, but this surgery.doesnt tell you that much since you know he is already stage 3 and the SNB is basically a staging tool to see if someone is stage 3. A clear SNB indicates very little in this case because he is already stage 3. All this surgery will indicate is if there is additional microscopic melanoma elsewhere. If the SNB is positive, they will want to remove all the lymph nodes in the area. If it is positive, maybe that will spur BIL along to push for a melanoma specialist and move him out of denial.
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- October 13, 2014 at 2:18 pm
*Are they able to tell patient the same day whether cancer found in any nodes, or does it take days? Days. They process in paraffin and stain the tissue to more easily identify melanocytes. Just like is done in biopsies.
*Can they easily identify in-transit metastases by looking at WLE tissue? Maybe if there are other in-transit tumors nearby, but it may not indicate if cells just moved thru the vessels to go outside the WLE tissue.
You can only hope about the oncologist, but this surgery.doesnt tell you that much since you know he is already stage 3 and the SNB is basically a staging tool to see if someone is stage 3. A clear SNB indicates very little in this case because he is already stage 3. All this surgery will indicate is if there is additional microscopic melanoma elsewhere. If the SNB is positive, they will want to remove all the lymph nodes in the area. If it is positive, maybe that will spur BIL along to push for a melanoma specialist and move him out of denial.
-
- October 13, 2014 at 2:18 pm
*Are they able to tell patient the same day whether cancer found in any nodes, or does it take days? Days. They process in paraffin and stain the tissue to more easily identify melanocytes. Just like is done in biopsies.
*Can they easily identify in-transit metastases by looking at WLE tissue? Maybe if there are other in-transit tumors nearby, but it may not indicate if cells just moved thru the vessels to go outside the WLE tissue.
You can only hope about the oncologist, but this surgery.doesnt tell you that much since you know he is already stage 3 and the SNB is basically a staging tool to see if someone is stage 3. A clear SNB indicates very little in this case because he is already stage 3. All this surgery will indicate is if there is additional microscopic melanoma elsewhere. If the SNB is positive, they will want to remove all the lymph nodes in the area. If it is positive, maybe that will spur BIL along to push for a melanoma specialist and move him out of denial.
-
- October 13, 2014 at 12:17 pm
Janner: Thank you, as always. It occurred to me that I didn't know whether lymph was involved in skin-to-skin metastasis, and on "Update" (excellent information, some of which I paid for with a 30-day subscription) I found material re: satellite metastases and in-transit metastasis. Thank goodness, BIL will have SLNB and WLE tomorrow morning, and then we'll know more. "Update" describes BIL's scenario as "clinical stage III" even if no node involvment found.
*Are they able to tell patient the same day whether cancer found in any nodes, or does it take days?
*Can they easily identify in-transit metastases by looking at WLE tissue?
*Is the surgeon (a general surgeon at a local hospital) likely to ask BIL if he has an oncologist, or to refer him to one/tell him that this is the next step? I'm hoping this is major component of proceedings….even hoping that maybe surgeon might mention Hopkins as option.
-
- October 13, 2014 at 12:17 pm
Janner: Thank you, as always. It occurred to me that I didn't know whether lymph was involved in skin-to-skin metastasis, and on "Update" (excellent information, some of which I paid for with a 30-day subscription) I found material re: satellite metastases and in-transit metastasis. Thank goodness, BIL will have SLNB and WLE tomorrow morning, and then we'll know more. "Update" describes BIL's scenario as "clinical stage III" even if no node involvment found.
*Are they able to tell patient the same day whether cancer found in any nodes, or does it take days?
*Can they easily identify in-transit metastases by looking at WLE tissue?
*Is the surgeon (a general surgeon at a local hospital) likely to ask BIL if he has an oncologist, or to refer him to one/tell him that this is the next step? I'm hoping this is major component of proceedings….even hoping that maybe surgeon might mention Hopkins as option.
-
- October 13, 2014 at 4:33 am
To go from one place on the skin to another, it travels through the lymph vessels. The path report mentions vessel involvement if I remember correctly. Blood vessels less likely as mets to organs are most likely then. When it travels thru the lymph vessels, it doesn't mean it has hit the lymph nodes yet, but that would be the most likely next stop. This type of spread would be called in-transit as long as it is within the same lymph basin as the primary. You get to make assumptions since you don't know for sure where the primary might have been. You can also look for sub-q's (subcutaneous mets) here and find other related posts.
-
- October 13, 2014 at 4:33 am
To go from one place on the skin to another, it travels through the lymph vessels. The path report mentions vessel involvement if I remember correctly. Blood vessels less likely as mets to organs are most likely then. When it travels thru the lymph vessels, it doesn't mean it has hit the lymph nodes yet, but that would be the most likely next stop. This type of spread would be called in-transit as long as it is within the same lymph basin as the primary. You get to make assumptions since you don't know for sure where the primary might have been. You can also look for sub-q's (subcutaneous mets) here and find other related posts.
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Tagged: cutaneous melanoma
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