› Forums › Cutaneous Melanoma Community › help with husband’s pathology report
- This topic has 9 replies, 2 voices, and was last updated 8 years, 12 months ago by
Janner.
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- May 7, 2015 at 2:16 am
Looking for help. Trying to understand my husband's pathology report. Doctors say his melanoma was in situ but I'm trying to understand because it doesn't say how big the margins are only that it was caught early and was low risk.
-residual malignant melanoma in situ
-margins are negative
-previous biospy site changes
Microscopic description: Sections show a proliferation of junctional melanocytes exhibiting confluent growth along the dermoepidemal junction and pagetoid spread. The tumor is located in close proximity to an area with changes consistent with a previous biopsy site. All margins are negative.
Gross Description-
Received in formalin, labled right ear lesion, is a irregular skin with subcutaneous tissue with a single stich marking superior and double stitch marking posterior. The specimen measures as follows: 2.2 cm from superior to inferior, 1.8 cm from anterior to posterior and 0.4 cm from superficial to deep. The specimen is inked as follows: Green for posterior half and black for anterior half.
I didn't go with him to his follow up appointment and just looking for some help understanding this.
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- May 7, 2015 at 3:19 am
So was this the wide excision? Since it says "residual melanoma" and previous biopsy, it appears this is the second surgery in the area. Obviously, the biopsy didn't have clear margins because there was residual melanoma. There is no indication of margins although the tissue removed may be large enough. The info may have been conveyed to your derm in another manner, but I see no reason not to confirm the margins. You want a minimum of 5mm but recent research actually says 9mm might be a better number. GIven the location, anatomy might dictate what is realistic. If your derm isn't forthcoming, you could request that the pathologist clarify things. Other than that, there is really nothing more about the report I could comment on. Yes, melanoma in situ is low risk but good margins are essential to stopping it right there.
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- May 7, 2015 at 11:35 am
Yes, this was done after a shave biopsy was done in the dermatologist's office. The surgeon said that the margins were 5 mm or greater, but we can't find that anywhere on the actual report, in writing. I'm wondering if I am missing a sheet from the report or whether the doctor is just assuming because the tissue he removed was so large. I'd like to know for sure and I don't he would say what the margins were without really knowing. He also told my husband that the shave biospy done first almost removed all of it, the surgery was aggressive (which my husband wanted) and more than sufficient. Advice? Thanks for your help.
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- May 7, 2015 at 3:52 pm
All you can do is either ask the surgeon or the pathologist for something in writing. Usually, path reports state margins, but not everyone follows the same format and something like that could have been communicated verbally. But if there isn't anything in writing, ask for a second opinion on someone reading the slides. Insurance should cover it.
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- May 7, 2015 at 3:52 pm
All you can do is either ask the surgeon or the pathologist for something in writing. Usually, path reports state margins, but not everyone follows the same format and something like that could have been communicated verbally. But if there isn't anything in writing, ask for a second opinion on someone reading the slides. Insurance should cover it.
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- May 7, 2015 at 3:52 pm
All you can do is either ask the surgeon or the pathologist for something in writing. Usually, path reports state margins, but not everyone follows the same format and something like that could have been communicated verbally. But if there isn't anything in writing, ask for a second opinion on someone reading the slides. Insurance should cover it.
-
- May 7, 2015 at 11:35 am
Yes, this was done after a shave biopsy was done in the dermatologist's office. The surgeon said that the margins were 5 mm or greater, but we can't find that anywhere on the actual report, in writing. I'm wondering if I am missing a sheet from the report or whether the doctor is just assuming because the tissue he removed was so large. I'd like to know for sure and I don't he would say what the margins were without really knowing. He also told my husband that the shave biospy done first almost removed all of it, the surgery was aggressive (which my husband wanted) and more than sufficient. Advice? Thanks for your help.
-
- May 7, 2015 at 11:35 am
Yes, this was done after a shave biopsy was done in the dermatologist's office. The surgeon said that the margins were 5 mm or greater, but we can't find that anywhere on the actual report, in writing. I'm wondering if I am missing a sheet from the report or whether the doctor is just assuming because the tissue he removed was so large. I'd like to know for sure and I don't he would say what the margins were without really knowing. He also told my husband that the shave biospy done first almost removed all of it, the surgery was aggressive (which my husband wanted) and more than sufficient. Advice? Thanks for your help.
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- May 7, 2015 at 3:19 am
So was this the wide excision? Since it says "residual melanoma" and previous biopsy, it appears this is the second surgery in the area. Obviously, the biopsy didn't have clear margins because there was residual melanoma. There is no indication of margins although the tissue removed may be large enough. The info may have been conveyed to your derm in another manner, but I see no reason not to confirm the margins. You want a minimum of 5mm but recent research actually says 9mm might be a better number. GIven the location, anatomy might dictate what is realistic. If your derm isn't forthcoming, you could request that the pathologist clarify things. Other than that, there is really nothing more about the report I could comment on. Yes, melanoma in situ is low risk but good margins are essential to stopping it right there.
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- May 7, 2015 at 3:19 am
So was this the wide excision? Since it says "residual melanoma" and previous biopsy, it appears this is the second surgery in the area. Obviously, the biopsy didn't have clear margins because there was residual melanoma. There is no indication of margins although the tissue removed may be large enough. The info may have been conveyed to your derm in another manner, but I see no reason not to confirm the margins. You want a minimum of 5mm but recent research actually says 9mm might be a better number. GIven the location, anatomy might dictate what is realistic. If your derm isn't forthcoming, you could request that the pathologist clarify things. Other than that, there is really nothing more about the report I could comment on. Yes, melanoma in situ is low risk but good margins are essential to stopping it right there.
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Tagged: cutaneous melanoma
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