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Desmoplastic Melanoma pathology different?

Forums General Melanoma Community Desmoplastic Melanoma pathology different?

  • Post
    alleycat
    Participant

    My husband was diagnosed with Desmoplastic Melanoma (DM) on the crown of his head, which is a rare type that affects anywhere from 1% – 4% of melanomas depending on what you read.  It also frequently recurs locally.  As such, the doctor says that the melanoma does not behave in the same ways as other types.  DM has no color usually, his was just a bump on his head.  As such, it usually goes undiagnosed and can get quite large before it gets recognized.  We thought it was a cyst.

    My husband was diagnosed with Desmoplastic Melanoma (DM) on the crown of his head, which is a rare type that affects anywhere from 1% – 4% of melanomas depending on what you read.  It also frequently recurs locally.  As such, the doctor says that the melanoma does not behave in the same ways as other types.  DM has no color usually, his was just a bump on his head.  As such, it usually goes undiagnosed and can get quite large before it gets recognized.  We thought it was a cyst.

    He had surgery 2 weeks ago to remove 2 cm margin around the site, replacing the tissue with a skin graft.  They did not do lymph node biopsy because of the location of the lymph nodes, and the percentage of lymph node involvement with DM is only 7% usually.   We got the pathology report back.  The margins were clear, but I'm concerned about the other things I'm reading in the path report.  When I look them up on the internet, most of the features look very negative.  The doctor says that DM doesn't follow the normal course, and I hope he's right.  Anyone know about this?  

    Here are the results:

    Top of scalp, excision:

    Histologic type:  Malignant melanoma, desmoplastic type, sectional edges involved comment.

    Clark's level:  V

    Breslow depth:  At least 0.5 cm

    Vertical growth phase:  Present

    Ulceration:  Absent.

    Lymphovascular invasion:  Absent.

    Perineural invasion:  Present

    Tumor infiltrating lymphocytes:  Not brisk.

    Regression:  Absent

    Mitotic figures:  Up to 5 per mm squared

    Tumor micros-satellites:  Absent

    Precursor lesions:  Absent

    "The lesion extends to and involves the deep inked margin and is <1 mm from the 12 o'clock inked margin.  The 3, 6, and 9 o'clock margins appear clear by >1.0 cm.  The separately submitted en face margins show multiple foci of atypical intraepidermal melanocytic proliferation which may represent a field effect phenomenon."

    Pathologic stage:  pT4a, pNX, pMX

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  • Replies
      molly
      Participant

      Sorry to have to welcome you to the board but you have found an excellent place filled with  knowledgeable folks who are willing to share their experiences and their hearts. I don't have any first hand knowledge of this type of melanoma but I am sure you will get others to respond. It is usually slow on the week end so don't be discouraged if  you don't get many replies today and tomorrow. 

      Wishing your husband the very best,

      molly

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        Nicky
        Participant

        Hi, I was diagnosed with a Desmoplastic melanoma on my arm  five years ago, it is a rare type of melanoma.  You can read my patnet under "Nicky"

        The Oncologists told me at the time that they treat them like a soft tissue sarcoma.  The difficulty with them is that because they tend not to be pigmented, people don't notice them so from what I was told it appears that most are quite deep by the time the doctors see them.

        I had the area treated with radiation therapy because as I had already had a normal type of melanoma go to my lymph nodes in my groin, I thought it was the best treatment to prevent a recurrence in the same area.

        There is lots of trials being done with Desmoplastic Melanoma at the moment as I understand it.

        All the best. 

         

         

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        Nicky
        Participant

        Hi, I was diagnosed with a Desmoplastic melanoma on my arm  five years ago, it is a rare type of melanoma.  You can read my patnet under "Nicky"

        The Oncologists told me at the time that they treat them like a soft tissue sarcoma.  The difficulty with them is that because they tend not to be pigmented, people don't notice them so from what I was told it appears that most are quite deep by the time the doctors see them.

        I had the area treated with radiation therapy because as I had already had a normal type of melanoma go to my lymph nodes in my groin, I thought it was the best treatment to prevent a recurrence in the same area.

        There is lots of trials being done with Desmoplastic Melanoma at the moment as I understand it.

        All the best. 

         

         

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      molly
      Participant

      Sorry to have to welcome you to the board but you have found an excellent place filled with  knowledgeable folks who are willing to share their experiences and their hearts. I don't have any first hand knowledge of this type of melanoma but I am sure you will get others to respond. It is usually slow on the week end so don't be discouraged if  you don't get many replies today and tomorrow. 

      Wishing your husband the very best,

      molly

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      Soupison
      Participant
      Desmoplastic-different? Just found out about this site. 2008 small unremarkable bump removed from left, front of scalp. It was desmoplastic and later removed with “cat’s eye’ surgery -margins clear. 2009 another bump about 3″ away, – desmoplastic, later removed by same type surgery -margins clear. 2010 another bump between the two surgeries – desmoplastic and removed by wide excision with right thigh skin graft – bottom not clear. 2010 Major wide excision ~ 6” round with thigh skin graft -margins and bottom clear. 2010 Two more bumps in vicinity of other surgeries -desmoplastic. MAJOR surgery – cancer removal, bone removal, implant of titanium & tissue transplant from good thigh. Bottom and margins clear. Followed with 25 radiation treatments. About 5 months since last surgery & 3 months since completing radiation. 20 March 2011

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      Soupison
      Participant
      Desmoplastic-different? Just found out about this site. 2008 small unremarkable bump removed from left, front of scalp. It was desmoplastic and later removed with “cat’s eye’ surgery -margins clear. 2009 another bump about 3″ away, – desmoplastic, later removed by same type surgery -margins clear. 2010 another bump between the two surgeries – desmoplastic and removed by wide excision with right thigh skin graft – bottom not clear. 2010 Major wide excision ~ 6” round with thigh skin graft -margins and bottom clear. 2010 Two more bumps in vicinity of other surgeries -desmoplastic. MAJOR surgery – cancer removal, bone removal, implant of titanium & tissue transplant from good thigh. Bottom and margins clear. Followed with 25 radiation treatments. About 5 months since last surgery & 3 months since completing radiation. 20 March 2011

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        LynnLuc
        Participant

        I wonder if it's related to Desmoplastic small round cell sarcoma…I lost my son when he was 16 to that…he was diagnosed  in 1996 July and passed away January 1998. It was in a lymph node in his abdomon at first and they told us less than 500 people ever had it and that it usually attacked fast growing boys… It was a swift cancer and treatment included radiation, chemo combo after chemo combo, BMT, stem cell rescue and surgery…it was awful and I am forever changed…I have stage 4 melanoma and I am NED for 1 year ( actually March 26 is my one year anniversary of NED)…

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        LynnLuc
        Participant

        I wonder if it's related to Desmoplastic small round cell sarcoma…I lost my son when he was 16 to that…he was diagnosed  in 1996 July and passed away January 1998. It was in a lymph node in his abdomon at first and they told us less than 500 people ever had it and that it usually attacked fast growing boys… It was a swift cancer and treatment included radiation, chemo combo after chemo combo, BMT, stem cell rescue and surgery…it was awful and I am forever changed…I have stage 4 melanoma and I am NED for 1 year ( actually March 26 is my one year anniversary of NED)…

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