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Dysplastic nevus with spitzoid features? melanoma

Forums Pediatric & AYA Melanoma Community Dysplastic nevus with spitzoid features? melanoma

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      Hi all, i’m wondering if anyone might be able to help. my son is now 14 years old. he had two dysplastic moles with mild atypia removed at about 4 years old. 4 years ago he had another dysplastic mole that was itching removed and shave biopsy showed dysplastic mole with spitzoid features, mild atypia. he had full excision with 1-2 mm margins with no recurrence. he now has just recently had another flat pigmented mole on his back shave biopsies with path report indicating dysplastic nevus with moderate dysplastic and spitzoid features. during this time of somewhat rapid growth of the lesion he also had an enlarged lymph node on the back of his head that has since decreased in size but was definitely there for approximately 2 months. they have not done any molecular testing on his previous lesion or this one? not sure if that is because it has only moderate dysplastic and not severe? dr is planning full excision with narrow 2mm margins. wondering if anyone has thoughts on need for second opinion or additional molecular testing or am i being crazy?

      Thanks all for any info,

      worried mom :scratch:

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          I understand your worry, I think we worry about our kids more than ourselves sometimes. If the moles have been cut off and then excised, they have done testing on them, that is how they determine that they are atypical nevi (spitzoid) and not actual melanoma, so they do know the make up of the tissue removed. On the lymph node, there are many reasons that lymph nodes become enlarged including various kinds of infections, inflamation etc. and if it swelled up then the swelling went down on its own, that is good sign that it is nothing to worry about.
          All this being said, if you are uncomfortable with the diagnosis and treatment by your current dermatologist, and you are worried, there is no reason why you shouldn’t seek a second opinion from another derm who works with melanoma patients. There are many much more literate and experienced peeps on this site than me, I suspect someone else will chime in and give you some advice more complete and better than mine.
          Blessings and peace to you,
          Danielle T
            Hi, I’ve had a spitzoid melanoma. My research has said if under 20 years old moles with spitzoid features are usually benign but over 20 years old they are not. It is very hard to determine the malignancy potential and spitzoid cells can move to the lymph glands and still not have malignancy potential.

            your dermatologist can send the mole to Castle Bioscience – they have a specific test to determine whether borderline moles have a malignant potential. They will work with you and your insurance to ensure it is not high out of pocket expense.
            you can also ask your dermatologist to send the mole for a second opinion to Mayo Clinic.

            but it sounds like based on his age and they are saying just spitzoid features (do not mention melanoma) the additional excision is all that needs to be done.


            ed williams
              Hi bmtrn, there used to be a lady on the forum that was an expert in types of nevi and gave great advice, her name is Janner. Search for her old post they are golden!!! I will include a video of a pathologist explaining with the use of slide what pathologist look at and look for in the tumor (nevus) slides. It really is  a world or language like no other and I don’t claim to be an expert in this area, just thought you might like to get an idea of what pathologist do in making decisions on slides under high powered  microscopes.
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