Do I have melanoma? Concerned about Melan-A and Mart-1 on path report
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Do I have melanoma? Concerned about Melan-A and Mart-1 on path report

› Forums › Cutaneous Melanoma Community › Do I have melanoma? Concerned about Melan-A and Mart-1 on path report

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    • May 10, 2018 at 8:56 pm
    pplexed
    Participant

    Had a mole removed from my great toe.  My derma did not seem too concerned.  However, I am concerned about the finding of Melan-A and Mart I.

     

    Path report:

    1 fragment of tan tissue received measuring 0.8 x 0.6 cm
    Compound nevus, dysplastic type, with moderate dysplasia. 
    Comments:  A conservative re-excision to ensure complete removal is advised
    Extending close to the base of the specimen, immunohistochemical staining reveal staining with Melan-A and Mart I that confirms the diagnosis
    The pathologic process is that of single and nested melanocytic proliferation along the dermal junction and in the dermis.  Moderate cytological atypia of melanocytes is noted. Bridging and fusing of adjacent rate is noted.  Superficial fibrosis of the papillary dermis is also seen.

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  • Replies
      • May 10, 2018 at 11:40 pm
      Julie in SoCal
      Participant

      Hi Anon,

      Your path report says that it is Compound nevus, dysplastic type, with moderate dysplasia. This is good news!  

      Melan-A / Mart 1 are not terribly helpful in diagnoising melanoma as positive Melan-A  can be found both on melanoma (or not) and on sun damaged skin.  So even if you were positive for Melan-A / Mart-1 stains you wouldn't necessarily have malanoma.  This is good news.

      Some melanom peeps have their biopsies read by multiple dermapathologists – especially dermopaths who see a lot of melanoma.  You may want to do this, to put your mind at ease.  But either way, the treatment is the same- conservative re-excision to remove whatever is left over from the biopsy.

      Wishing you peace!

      Julie

        • May 11, 2018 at 9:42 am
        pplexed
        Participant
        Julie?
        Thank you. My concern is that the pathology “single and nests of melanocytes with invasion into the dermis” are consistent with Melanoma. What is the difference?
        • May 11, 2018 at 5:15 pm
        Julie in SoCal
        Participant

        Hi Pplexed,

        Compound nevus and Melanoma in situ (MIS) are very close and it takes an experienced dermapath to make the call and even then experienced dermapaths may disagree on the same slide.

        This said, there is no difference in treatment if you have a abnormal compound nevus or if you have Melanoma in situ. 

        My advice to you is to have the wide excision and then keep watching your moles for change. Look for change and ugly duckling moles (the one that just dosen't look like the others).  You've done well to have this one looked at by a derm and have possibly caught it early (not all compound nevus turn into melanoma).  Well done!

        Peace,

        Julie

         

        • May 11, 2018 at 5:21 pm
        pplexed
        Participant
        Ok, a sincere thank you. My concern is the invasion into the dermis. Please correct me if I am wrong, but is invasion into the dermis still in situ?
        • May 11, 2018 at 6:53 pm
        Julie in SoCal
        Participant

        I am not a pathologist, so I can't tell you more than this.  If you don't think your biopsy has be read right request a second opinion.  Or if you don't understand you report, talk with your derm.  He or she should be able to explain it.

        Take heart in this: what I do know is that for treatment, the reality of what comes next doesn't change up to Stage 2. 

        There may be others more knowledge about reading a path report here and they might chime in.  But talk with your derm. about the specifics in your path report 

        Sorry,

        Julie

      • May 11, 2018 at 7:21 pm
      Janner
      Participant

      This is a moderately atypical nevus, nothing more.  Nested melanocytes along the epidermal junction is the definition of a compound nevus.  The stains are used to confirm melanocytes – then the pathologist determines how normal or atypical those melanocytes are.

      Reading the description of the pathology report isn't that helpful because everything in that description should be justifying the final diagnosis.  You shouldn't have to interpret it differently than the pathologist did.  Julie is right, if you are not happy with the pathologist or want a second opinion, get it read again.  But don't second guess what is written in the existing report as that is counterproductive.

      Personally, a moderately atypical lesion is still a long way from melanoma in situ for me and I'd just have the conservative re-excision and move on.  You have to do what makes you feel comfortable.

        • May 12, 2018 at 4:11 am
        pplexed
        Participant
        Janner, and Julie thank you both! Your experience, and knowledge is outstanding.
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