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Confused by path report: In Situ and Invasive Mel in same lesion?
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Confused by path report: In Situ and Invasive Mel in same lesion?

› Forums › General Melanoma Community › Confused by path report: In Situ and Invasive Mel in same lesion?

  • Post
    • March 10, 2021 at 7:06 pm
    MeganD
    Participant
      Hi all –

      I am confused by my recent path report which I read after leaving the Dr.’s office, so I could not ask him. Source of my confusion is in bold, the reset is included for context.

      Diagnosis:  INVASIVE MELANOMA, BRESLOW THICKNESS 0.3, NON-ULCERATED (0 mitosis)

      NOTE: Sox-10 highlights an asymmetric compound melanocytic proliferation comprised of single and nested melanocytes in disarray along the dermal-epidermal junction and similar melanocytes in the superficial dermis. PRAME shows strong, uniform positivity throughout the lesional melanocytes, There are a few smaller melanocytes scattered in the dermis lacking PRAME reactivity which are interpreted as an associated melanocytic nevus, These finding support the diagnosis.

      Margins, peripheral and deep: melanoma in situ present at peripheral biopsy margin; deep biopsy margin narrowly free of melanoma.

      So, this lesion was both invasive and in situ? Or, is there additional in situ that goes outside the edges of the biopsy?

      I appreciate any insights you all might have in interpreting this.

      Thanks much.

      Megan

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    • Replies
        • March 10, 2021 at 10:18 pm
        KAP715
        Participant
          I believe what the report is saying is that you don’t have clear margins and will need a wide excision to remove all the melanoma cells.
          • March 11, 2021 at 1:42 am
          QuietPoet
          Participant
            So, it looks like it hasn’t entered the depth invasion stage, and it’s only spreading in the top dermal layer (this is good!) It means it’s “in situ” so its Level 0. Get a WLE (wide local excision) now before it starts going deeper. You will never probably have to worry about it again, and the depth of the WLE won’t be that bad. Great news!

             

            • March 11, 2021 at 10:40 am
            MeganD
            Participant
              Thank you for your responses. The path report staged it as pT1a, pNX.  Which would indicate that it is more than In Situ, so…confusing.  (Healing from WLE now!).

               

               

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