› Forums › General Melanoma Community › Janner and stage 1bs I’m back! Got some more issues…
- This topic has 9 replies, 3 voices, and was last updated 11 years, 9 months ago by
Janner.
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- August 9, 2012 at 8:39 pm
HiI’m 2 months put from WLE and SLNB for a stage 1 b melanoma on upper arm so tensions are still high.
I went in for my first melanoma skin checkup and Derm was rushed. I pointed out 2 very small brown pigmented “things” that didn’t even resemble a mole. I am fair skinned and they looked like a freckle- honestly.
Derm reluctant to take them off saying nothing to worry about but I persisted. Here are the results:
Lt arm: pigmented surface lesion 0.3 cm in greatest dimension. Sections show slight elongation of rete ridges and a proliferation of mildly atypical melanocytes arranged mainly as single cells with rare nests along the dermal epidermal junction. The melanocytes possess lightly pigmented cytoplasm. There is a rare melanocyte noted above the basal cell layer. There is fusion of rete ridges and lamellar fibroplasia. In the dermis isa band- like arrangement of benign nevus cells, scattered melanophages and a mild lymphocytic infiltrate. Histology that of a Dysplastic nevus with unusual features. Conservative re excision of scar recommended.
Left breast: pigmented surface lesion 0.3 mm in greatest dimension. This is a thin shave biopsy which shows elongation of rete ridges and a proliferation of mildly atypical melanocytes with lightly pigmented cytoplasm arranged mainly in a lentiginous pattern along the dermal- epidermal junction with rare nests. There is a rare melanocyte noted above basal cell layer. The epidermis is vocally excoriated and rare necrotic keratinocytes are noted within the superficial epidermis. There is a fusion of rete ridges and lamellar fibroplasia. In the dermis is a rare nest of benign nevus cells scattered melanophages and a mild lymphocytic infiltrate. Histology is that of a dynastic nevus which has been excoriated. Although the rare scatter can be explained by local trauma and special site, it would be prudent to re excise scar with conservative margins.
Now I’m off to plastic surgeon ! What should I do moving forward? I have a few of these very ” innocent” looking freckles on my back that do not have elevation and look normal? The Derm didn’t want to pursue taking even these ones above off for pathology! Should I be worried a d get a other skin check done before my next scheduled in 3 months? And I sits every “freckle” that looks like the ones on breast and arm be taken off?
Thanks friends,
Francesca
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- August 9, 2012 at 9:01 pm
The first one reads like mildly atypical. .I've had about 20 of that kind removed, never have had re-excision on any of them, even if margins were involved. I didn't think they usually do anything about mildly atypical – maybe for moderately/severely atypical they would re-excise, but not mildly. Some of us – our bodies just produce mildly dysplastic nevi and most of what we get removed would show some atypia.
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- August 9, 2012 at 9:08 pm
Thanks Janner! I know I can count on you to reply! I know this sounds vain but I don’t want worse scars ESP on my breast and a very visible part of my arm! My WLE from my melanoma on upper arm looks ghastly! I’m using cica strips which are silicone to help appearance but so far it’s still horrible looking. Since its in an area of high tension the scar is thicker than many other WLE I saw at Juravinski cancer centre. Now I’m facing more surgery, stitches and scars- should I ask plastic surgeon more questions? What should I ask? Can I avoid even more excisions? Why do you think this pathologist recommended this? -
- August 9, 2012 at 9:08 pm
Thanks Janner! I know I can count on you to reply! I know this sounds vain but I don’t want worse scars ESP on my breast and a very visible part of my arm! My WLE from my melanoma on upper arm looks ghastly! I’m using cica strips which are silicone to help appearance but so far it’s still horrible looking. Since its in an area of high tension the scar is thicker than many other WLE I saw at Juravinski cancer centre. Now I’m facing more surgery, stitches and scars- should I ask plastic surgeon more questions? What should I ask? Can I avoid even more excisions? Why do you think this pathologist recommended this? -
- August 9, 2012 at 9:08 pm
Thanks Janner! I know I can count on you to reply! I know this sounds vain but I don’t want worse scars ESP on my breast and a very visible part of my arm! My WLE from my melanoma on upper arm looks ghastly! I’m using cica strips which are silicone to help appearance but so far it’s still horrible looking. Since its in an area of high tension the scar is thicker than many other WLE I saw at Juravinski cancer centre. Now I’m facing more surgery, stitches and scars- should I ask plastic surgeon more questions? What should I ask? Can I avoid even more excisions? Why do you think this pathologist recommended this?
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- August 9, 2012 at 9:01 pm
The first one reads like mildly atypical. .I've had about 20 of that kind removed, never have had re-excision on any of them, even if margins were involved. I didn't think they usually do anything about mildly atypical – maybe for moderately/severely atypical they would re-excise, but not mildly. Some of us – our bodies just produce mildly dysplastic nevi and most of what we get removed would show some atypia.
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- August 9, 2012 at 9:01 pm
The first one reads like mildly atypical. .I've had about 20 of that kind removed, never have had re-excision on any of them, even if margins were involved. I didn't think they usually do anything about mildly atypical – maybe for moderately/severely atypical they would re-excise, but not mildly. Some of us – our bodies just produce mildly dysplastic nevi and most of what we get removed would show some atypia.
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- August 10, 2012 at 12:13 am
Was there a "Final Diagnosis" on either? Both look more or less mildly atypical. If there weren't clean margins, some derms will ask for complete removal while others not. There is no hard and fast rule for that. It appears the second one was a shave that was very superficial (not a good choice if melanoma is really suspected). Some of the pathology description may be due to the shave and not a problem at all. To me, it sounds like the pathologist is covering his butt (excuse my language) in asking for re-excisions. Neither of these lesions needed to be removed – the only reason more is being taken is because, most likely, some is left behind. Mildly atypical lesions almost never become melanoma. If you have a few of these lesions – these are not the ones you are looking for. You're looking for the ONE ugly duckling – not something you have multiples of. LOOK FOR CHANGE! LOOK FOR THE LESION THAT IS DIFFERENT FROM EVERYTHING ELSE! That's the best advice I can give.
Janner
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- August 10, 2012 at 12:13 am
Was there a "Final Diagnosis" on either? Both look more or less mildly atypical. If there weren't clean margins, some derms will ask for complete removal while others not. There is no hard and fast rule for that. It appears the second one was a shave that was very superficial (not a good choice if melanoma is really suspected). Some of the pathology description may be due to the shave and not a problem at all. To me, it sounds like the pathologist is covering his butt (excuse my language) in asking for re-excisions. Neither of these lesions needed to be removed – the only reason more is being taken is because, most likely, some is left behind. Mildly atypical lesions almost never become melanoma. If you have a few of these lesions – these are not the ones you are looking for. You're looking for the ONE ugly duckling – not something you have multiples of. LOOK FOR CHANGE! LOOK FOR THE LESION THAT IS DIFFERENT FROM EVERYTHING ELSE! That's the best advice I can give.
Janner
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- August 10, 2012 at 12:13 am
Was there a "Final Diagnosis" on either? Both look more or less mildly atypical. If there weren't clean margins, some derms will ask for complete removal while others not. There is no hard and fast rule for that. It appears the second one was a shave that was very superficial (not a good choice if melanoma is really suspected). Some of the pathology description may be due to the shave and not a problem at all. To me, it sounds like the pathologist is covering his butt (excuse my language) in asking for re-excisions. Neither of these lesions needed to be removed – the only reason more is being taken is because, most likely, some is left behind. Mildly atypical lesions almost never become melanoma. If you have a few of these lesions – these are not the ones you are looking for. You're looking for the ONE ugly duckling – not something you have multiples of. LOOK FOR CHANGE! LOOK FOR THE LESION THAT IS DIFFERENT FROM EVERYTHING ELSE! That's the best advice I can give.
Janner
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Tagged: cutaneous melanoma
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