› Forums › General Melanoma Community › Need help reading a pathology report
- This topic has 33 replies, 3 voices, and was last updated 11 years, 1 month ago by
Arlenellen.
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- May 4, 2013 at 9:14 pm
My husband recently had a SLNB and a right cheek excision with plastic surgery. Although the results said there was no evidence of residual invasive melanoma on his cheek, it also states “residual melanoma in situ in a background of cicatrix. It then goes on to state, melanoma in situ measures0.4 cm in horizontal dimension and lies 0.4 cm from the nearest epidermal edge or resection. All surgical margins negative for melanoma.
The lymph node came back negative for melanoma. I am very confused. Can someone more experienced than I help me understand this? BTW the histologic type is nodual which I understand to be the fastest growing.Thank you
Arlene
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- May 4, 2013 at 10:07 pm
It's typically more helpful when you can post the entire report as opposed to bits and pieces. But basically, it means that while they didn't find any residual melanoma deep in the lesion, they found some on the surface in the scar tissue from the biopsy. Basically, the original biopsy wasn't wide enough to remove all the melanoma in situ at the surface, but did manage to get the complete depth. Was this a punch biopsy? Are they planning to do another excision? In general, you want at least 5mm of clear margins from in situ. While this is close, depending on the depth of the lesion, I might consider having more taken. Since the SNB is negative, I'd probably be of the thought that surgery is still the best weapon against early melanoma and I'd probably be pretty aggressive trying to remove any remaining cells.
Best wishes,
Janner
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- May 4, 2013 at 11:58 pm
Janner,
Thank you for your response. I’ll try to be more precise. My husband had a lesion on his cheek removed in march. The dermatologist did a shave biopsy. The path report came back as nodular melanoma. It was .95mm in depth. The dermatologist found us a surgeon. We went to the surgeon and because the lesion was so close to his mouth he told us we would need a plastic surgeon. When the surgeon came out of surgery he told me the plastic surgeon did the wide excision before he did the SLNB which I knew,from reading about the surgery was not the proper protocol. Anyway below is the path report.
Final diagnosis:
A. Excision right cheek lesion:
Residual melanoma in situ in a background of cicatrix
Melanoma in situ measures o.4 cm (4mm) in horizontal dimension and lies 0.4 cm from the nearest epidermal edge of resection (6:00-9:00)
All surgical margins negative for melanoma
No evidence of residual invasive melanoma.
B: Cervical sentinel lymph node:
Single lymph node negative for metastatic melanomaComments:
There is residual melanoma in situ within the previous biopsy area highlighted on a melanoma A immunostaining. There is no residual vertical component. The separately submitted sentinel node is negative for malignancy (H&E, Melanoma A and HMB45 immunostaining.)There is then information on the staging study which is 1b.
Ancillary studies:
Immunohistochemisty;
Material: Block A3
Population: Tumor cells
Antibody Result
MART-1 (MELAN A) red chomogen. PositiveSorry for such a lengthy note.
Arlene
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- May 5, 2013 at 2:39 am
Thanks for posting the whole report, it just helps to make sure we have the whole picture when trying to comment. So, are there any plans to do more surgery or are you going to leave things as-is?
Good news for catching a nodular lesion so early.
Best wishes,
Janner
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- May 5, 2013 at 2:39 am
Thanks for posting the whole report, it just helps to make sure we have the whole picture when trying to comment. So, are there any plans to do more surgery or are you going to leave things as-is?
Good news for catching a nodular lesion so early.
Best wishes,
Janner
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- May 5, 2013 at 12:56 pm
I think our next step is to find a good melanoma specialist. This is all so new to us. I still don’t understand what the ramifications are regarding the residual melanoma in situ. Will it grow into another nodular melanoma? What kind of surgery would he need? He just finished six months of tough chemo for a rare lymphoma he’s been dealing with for 13 years. Needless to say he is pretty upset knowing he may have to have more surgery. Tough decisions are ahead. -
- May 5, 2013 at 12:56 pm
I think our next step is to find a good melanoma specialist. This is all so new to us. I still don’t understand what the ramifications are regarding the residual melanoma in situ. Will it grow into another nodular melanoma? What kind of surgery would he need? He just finished six months of tough chemo for a rare lymphoma he’s been dealing with for 13 years. Needless to say he is pretty upset knowing he may have to have more surgery. Tough decisions are ahead. -
- May 5, 2013 at 2:23 pm
All the visible melanoma was removed including the in situ portion. In situ just means cells confined in the epidermis. If his melanoma were to recur, it could happen locally on the face or it could be in the neck lymph basin or elsewhere.
Melanoma basically has guidelines on margins. Larger margins try to guarantee that any rogue cells that might have left the primary tumor are all removed. My question would be that since they found residual melanoma in the peripheral margins, should more tissue be taken to get larger margins? Certainly a question for a specialist. Melanoma can be a tough cancer to treat once it goes beyond the initial site so getting good margins now is truly key. No one wants additional surgery – especially on the face. But no one wants to battle this cancer either if it spreads. So I believe it is a question worth bringing up. This is only my concern, but it would be a question I would be asking were this happening to me.
Best wishes,
Janner
-
- May 5, 2013 at 2:23 pm
All the visible melanoma was removed including the in situ portion. In situ just means cells confined in the epidermis. If his melanoma were to recur, it could happen locally on the face or it could be in the neck lymph basin or elsewhere.
Melanoma basically has guidelines on margins. Larger margins try to guarantee that any rogue cells that might have left the primary tumor are all removed. My question would be that since they found residual melanoma in the peripheral margins, should more tissue be taken to get larger margins? Certainly a question for a specialist. Melanoma can be a tough cancer to treat once it goes beyond the initial site so getting good margins now is truly key. No one wants additional surgery – especially on the face. But no one wants to battle this cancer either if it spreads. So I believe it is a question worth bringing up. This is only my concern, but it would be a question I would be asking were this happening to me.
Best wishes,
Janner
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- May 5, 2013 at 2:51 pm
Still don’t understand. You said “all the visible melanoma was removed including the in situ portion”. But path report said they found residual melanoma in situ. Sorry to be so dense. Just trying to get everything straight. -
- May 5, 2013 at 2:51 pm
Still don’t understand. You said “all the visible melanoma was removed including the in situ portion”. But path report said they found residual melanoma in situ. Sorry to be so dense. Just trying to get everything straight. -
- May 5, 2013 at 2:51 pm
Still don’t understand. You said “all the visible melanoma was removed including the in situ portion”. But path report said they found residual melanoma in situ. Sorry to be so dense. Just trying to get everything straight. -
- May 5, 2013 at 6:58 pm
The biopsy removed the central and deepest portion of the melanoma. When they did the re-excision, they found melanoma in situ in the scar area from the biopsy. However, the wide excision removed all that melanona and had 4mm margins clear.
Residual melanoma in situ in a background of cicatrix (Melanoma in situ found in scar from biopsy)
Melanoma in situ measures o.4 cm (4mm) in horizontal dimension and lies 0.4 cm from the nearest epidermal edge of resection (6:00-9:00) (Melanoma is 4mm in width and there is 4mm clear tissue between this melanoma and the edge of wide excision tissue).
All surgical margins negative for melanoma. (No melanoma seen at the edges of the wide excision).So the wide excision had clear margins, but the 6-9 o'clock margin only had 4mm margins from the residual melanoma in situ. For a stage Iesion, you typically want 1cm clear margins. Melanoma in situ usually requires 5mm margins. But since this was a stage I lesion and there is only 4mm from the one margin, it might be worth discussing having additional tissue taken.
Does this help?
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- May 5, 2013 at 6:58 pm
The biopsy removed the central and deepest portion of the melanoma. When they did the re-excision, they found melanoma in situ in the scar area from the biopsy. However, the wide excision removed all that melanona and had 4mm margins clear.
Residual melanoma in situ in a background of cicatrix (Melanoma in situ found in scar from biopsy)
Melanoma in situ measures o.4 cm (4mm) in horizontal dimension and lies 0.4 cm from the nearest epidermal edge of resection (6:00-9:00) (Melanoma is 4mm in width and there is 4mm clear tissue between this melanoma and the edge of wide excision tissue).
All surgical margins negative for melanoma. (No melanoma seen at the edges of the wide excision).So the wide excision had clear margins, but the 6-9 o'clock margin only had 4mm margins from the residual melanoma in situ. For a stage Iesion, you typically want 1cm clear margins. Melanoma in situ usually requires 5mm margins. But since this was a stage I lesion and there is only 4mm from the one margin, it might be worth discussing having additional tissue taken.
Does this help?
-
- May 5, 2013 at 6:58 pm
The biopsy removed the central and deepest portion of the melanoma. When they did the re-excision, they found melanoma in situ in the scar area from the biopsy. However, the wide excision removed all that melanona and had 4mm margins clear.
Residual melanoma in situ in a background of cicatrix (Melanoma in situ found in scar from biopsy)
Melanoma in situ measures o.4 cm (4mm) in horizontal dimension and lies 0.4 cm from the nearest epidermal edge of resection (6:00-9:00) (Melanoma is 4mm in width and there is 4mm clear tissue between this melanoma and the edge of wide excision tissue).
All surgical margins negative for melanoma. (No melanoma seen at the edges of the wide excision).So the wide excision had clear margins, but the 6-9 o'clock margin only had 4mm margins from the residual melanoma in situ. For a stage Iesion, you typically want 1cm clear margins. Melanoma in situ usually requires 5mm margins. But since this was a stage I lesion and there is only 4mm from the one margin, it might be worth discussing having additional tissue taken.
Does this help?
-
- May 5, 2013 at 2:23 pm
All the visible melanoma was removed including the in situ portion. In situ just means cells confined in the epidermis. If his melanoma were to recur, it could happen locally on the face or it could be in the neck lymph basin or elsewhere.
Melanoma basically has guidelines on margins. Larger margins try to guarantee that any rogue cells that might have left the primary tumor are all removed. My question would be that since they found residual melanoma in the peripheral margins, should more tissue be taken to get larger margins? Certainly a question for a specialist. Melanoma can be a tough cancer to treat once it goes beyond the initial site so getting good margins now is truly key. No one wants additional surgery – especially on the face. But no one wants to battle this cancer either if it spreads. So I believe it is a question worth bringing up. This is only my concern, but it would be a question I would be asking were this happening to me.
Best wishes,
Janner
-
- May 5, 2013 at 10:33 pm
I was diagnised 01/07/13 with stage III –in the work up for adjuant therapy I was found to have a very rare Lymphoma-Waldenstroums Macroglobuliema Lymphoma. So now I am in the Watchful Waiting phase. Having Lymphoma I am not a candiate for any type of Chemo as my immune system is so comprimised from the Lymphoma. We are also in the Watch mode for the Lymphoma. (lol) I have been to MD Anderson for the 2nd opinion and they are in agreement with my currnet Hem/oc team. So I am curious about your story and the lymphoma…I was told that I have probably had W-M Lymphoma for many years( which I knew something was wrong but could not find a physican who could diagnois my vague symptoms) unitl now. I ask my team if the melanoma was an opportunistic cancer due to the weaken immune system from the Lymphoma….he said it was very possible….So now I am researching and wandering how this changes my recurrence/prognosis …..
-
- May 5, 2013 at 10:33 pm
I was diagnised 01/07/13 with stage III –in the work up for adjuant therapy I was found to have a very rare Lymphoma-Waldenstroums Macroglobuliema Lymphoma. So now I am in the Watchful Waiting phase. Having Lymphoma I am not a candiate for any type of Chemo as my immune system is so comprimised from the Lymphoma. We are also in the Watch mode for the Lymphoma. (lol) I have been to MD Anderson for the 2nd opinion and they are in agreement with my currnet Hem/oc team. So I am curious about your story and the lymphoma…I was told that I have probably had W-M Lymphoma for many years( which I knew something was wrong but could not find a physican who could diagnois my vague symptoms) unitl now. I ask my team if the melanoma was an opportunistic cancer due to the weaken immune system from the Lymphoma….he said it was very possible….So now I am researching and wandering how this changes my recurrence/prognosis …..
-
- May 6, 2013 at 4:43 pm
Kathy,
Thanks for your reply. My husband has Waldenstrom’s also. He’s had it for 13 years. When were you diagnosed with it? I too am worried about the ramifications of having both of these diseases. Dave, my husband just finished six months of Bendamustine and Rituxan and had a very hard time with the chemo and his immune system is compomised. I’m just beginning to learn about melanoma and it scares me to death. The web site is a God send. Are you a member of the IWMF? They have website that is extremely helpful and they also have a listserve where you can ask questions. The participants are very, very knowledgable and I have learned so much from them. As for the melanoma dilemma…we are in the process of finding a melanoma specialist that will work with our WM specialist. Please keep in touch. Maybe we can give each other strength and hope.
Arlene -
- May 6, 2013 at 4:43 pm
Kathy,
Thanks for your reply. My husband has Waldenstrom’s also. He’s had it for 13 years. When were you diagnosed with it? I too am worried about the ramifications of having both of these diseases. Dave, my husband just finished six months of Bendamustine and Rituxan and had a very hard time with the chemo and his immune system is compomised. I’m just beginning to learn about melanoma and it scares me to death. The web site is a God send. Are you a member of the IWMF? They have website that is extremely helpful and they also have a listserve where you can ask questions. The participants are very, very knowledgable and I have learned so much from them. As for the melanoma dilemma…we are in the process of finding a melanoma specialist that will work with our WM specialist. Please keep in touch. Maybe we can give each other strength and hope.
Arlene -
- May 7, 2013 at 12:05 am
Arlene,
Dispite years of seeing different physicians for my neuropathy,elevated serum protein and other problems I was never given a clear diagnoisis. I have walked out of more MD offices than you can count(lol). My sysmtpoms started in my early 30"s – way young for this type of Lymphoma… I was diagnoised in January 2013 with melanoma. We all believed I had Breast cancer as the 4cm x 4cm lymph node was in the left axillary area. No mole changes any where that I could see. Turns out a tiny freckle of a mole on my left breast was the primary. During my work up for adjuant treatment options to everyones surprise( except me) my serum protein was 11.2- The hem/onc team did a bone marrow(ouch) and I recieved the diagnosis of WM. I am told that I will start chemo in 3 weeks if my IGM continues to climb. I am praying for no Chemo..So which do I worry about more..The stage III melanoma or the WM Lymphoma? lol…both! I was told by my team in Shreveport, Louisiana and at MD Anderson that I am not a candiate for any treatment for the melanoma due to the WM…Lordy, Lordy…What a life change in such a short time…My oldest daughter is now having the same symptoms at 38. W-M can pass around int he family. So we are worried, I was advised to have all my children(red-heads) tested and followed for life for both cancers. Please keep in touch…thanks for the info on the web site…I will go there..
-
- May 7, 2013 at 12:05 am
Arlene,
Dispite years of seeing different physicians for my neuropathy,elevated serum protein and other problems I was never given a clear diagnoisis. I have walked out of more MD offices than you can count(lol). My sysmtpoms started in my early 30"s – way young for this type of Lymphoma… I was diagnoised in January 2013 with melanoma. We all believed I had Breast cancer as the 4cm x 4cm lymph node was in the left axillary area. No mole changes any where that I could see. Turns out a tiny freckle of a mole on my left breast was the primary. During my work up for adjuant treatment options to everyones surprise( except me) my serum protein was 11.2- The hem/onc team did a bone marrow(ouch) and I recieved the diagnosis of WM. I am told that I will start chemo in 3 weeks if my IGM continues to climb. I am praying for no Chemo..So which do I worry about more..The stage III melanoma or the WM Lymphoma? lol…both! I was told by my team in Shreveport, Louisiana and at MD Anderson that I am not a candiate for any treatment for the melanoma due to the WM…Lordy, Lordy…What a life change in such a short time…My oldest daughter is now having the same symptoms at 38. W-M can pass around int he family. So we are worried, I was advised to have all my children(red-heads) tested and followed for life for both cancers. Please keep in touch…thanks for the info on the web site…I will go there..
-
- May 10, 2013 at 4:27 pm
Kathy,
When Dave started having symptoms the doctors told him he had Crohn’s disease. When the medication didn’t work they sent him to Mayo. They had the lymphoma diagnosis in one day. The specialist at Mayo said if you had to get cancer WM would be the one to choose since it was slow growing and pretty treatable. Of course that didn’t make us feel any better but over the years we have come to see how fortunate we really are. Although he has had some bad days, he has been able to live a pretty normal life. His biggest problem is fatigue and anemia. I’ve heard of WM folks walking around with IGMs of 10,000. Dave’s symptoms start kicking in when his IGM goes to 2000 so he usually needs more treatment more often. Rituxan has been his chemo of choice since he was diagnosed. It works very well for him but others react differently. What chemo are you going to start? What is your IGM? What other symptoms do you have. With WM you treat the symptoms not the numbers. Now for the melanoma, why is it that you can’t have treatment for that but you can have treatment for WM? I really am interested in why that can be since Dave may someday be in you situation. I’m so sorry for all you’re going through. It’s tough but hang in there and no that I’m thinking of you and wishing for the very best.
Arlene -
- May 10, 2013 at 4:27 pm
Kathy,
When Dave started having symptoms the doctors told him he had Crohn’s disease. When the medication didn’t work they sent him to Mayo. They had the lymphoma diagnosis in one day. The specialist at Mayo said if you had to get cancer WM would be the one to choose since it was slow growing and pretty treatable. Of course that didn’t make us feel any better but over the years we have come to see how fortunate we really are. Although he has had some bad days, he has been able to live a pretty normal life. His biggest problem is fatigue and anemia. I’ve heard of WM folks walking around with IGMs of 10,000. Dave’s symptoms start kicking in when his IGM goes to 2000 so he usually needs more treatment more often. Rituxan has been his chemo of choice since he was diagnosed. It works very well for him but others react differently. What chemo are you going to start? What is your IGM? What other symptoms do you have. With WM you treat the symptoms not the numbers. Now for the melanoma, why is it that you can’t have treatment for that but you can have treatment for WM? I really am interested in why that can be since Dave may someday be in you situation. I’m so sorry for all you’re going through. It’s tough but hang in there and no that I’m thinking of you and wishing for the very best.
Arlene -
- May 10, 2013 at 4:27 pm
Kathy,
When Dave started having symptoms the doctors told him he had Crohn’s disease. When the medication didn’t work they sent him to Mayo. They had the lymphoma diagnosis in one day. The specialist at Mayo said if you had to get cancer WM would be the one to choose since it was slow growing and pretty treatable. Of course that didn’t make us feel any better but over the years we have come to see how fortunate we really are. Although he has had some bad days, he has been able to live a pretty normal life. His biggest problem is fatigue and anemia. I’ve heard of WM folks walking around with IGMs of 10,000. Dave’s symptoms start kicking in when his IGM goes to 2000 so he usually needs more treatment more often. Rituxan has been his chemo of choice since he was diagnosed. It works very well for him but others react differently. What chemo are you going to start? What is your IGM? What other symptoms do you have. With WM you treat the symptoms not the numbers. Now for the melanoma, why is it that you can’t have treatment for that but you can have treatment for WM? I really am interested in why that can be since Dave may someday be in you situation. I’m so sorry for all you’re going through. It’s tough but hang in there and no that I’m thinking of you and wishing for the very best.
Arlene -
- May 7, 2013 at 12:05 am
Arlene,
Dispite years of seeing different physicians for my neuropathy,elevated serum protein and other problems I was never given a clear diagnoisis. I have walked out of more MD offices than you can count(lol). My sysmtpoms started in my early 30"s – way young for this type of Lymphoma… I was diagnoised in January 2013 with melanoma. We all believed I had Breast cancer as the 4cm x 4cm lymph node was in the left axillary area. No mole changes any where that I could see. Turns out a tiny freckle of a mole on my left breast was the primary. During my work up for adjuant treatment options to everyones surprise( except me) my serum protein was 11.2- The hem/onc team did a bone marrow(ouch) and I recieved the diagnosis of WM. I am told that I will start chemo in 3 weeks if my IGM continues to climb. I am praying for no Chemo..So which do I worry about more..The stage III melanoma or the WM Lymphoma? lol…both! I was told by my team in Shreveport, Louisiana and at MD Anderson that I am not a candiate for any treatment for the melanoma due to the WM…Lordy, Lordy…What a life change in such a short time…My oldest daughter is now having the same symptoms at 38. W-M can pass around int he family. So we are worried, I was advised to have all my children(red-heads) tested and followed for life for both cancers. Please keep in touch…thanks for the info on the web site…I will go there..
-
- May 6, 2013 at 4:43 pm
Kathy,
Thanks for your reply. My husband has Waldenstrom’s also. He’s had it for 13 years. When were you diagnosed with it? I too am worried about the ramifications of having both of these diseases. Dave, my husband just finished six months of Bendamustine and Rituxan and had a very hard time with the chemo and his immune system is compomised. I’m just beginning to learn about melanoma and it scares me to death. The web site is a God send. Are you a member of the IWMF? They have website that is extremely helpful and they also have a listserve where you can ask questions. The participants are very, very knowledgable and I have learned so much from them. As for the melanoma dilemma…we are in the process of finding a melanoma specialist that will work with our WM specialist. Please keep in touch. Maybe we can give each other strength and hope.
Arlene -
- May 5, 2013 at 10:33 pm
I was diagnised 01/07/13 with stage III –in the work up for adjuant therapy I was found to have a very rare Lymphoma-Waldenstroums Macroglobuliema Lymphoma. So now I am in the Watchful Waiting phase. Having Lymphoma I am not a candiate for any type of Chemo as my immune system is so comprimised from the Lymphoma. We are also in the Watch mode for the Lymphoma. (lol) I have been to MD Anderson for the 2nd opinion and they are in agreement with my currnet Hem/oc team. So I am curious about your story and the lymphoma…I was told that I have probably had W-M Lymphoma for many years( which I knew something was wrong but could not find a physican who could diagnois my vague symptoms) unitl now. I ask my team if the melanoma was an opportunistic cancer due to the weaken immune system from the Lymphoma….he said it was very possible….So now I am researching and wandering how this changes my recurrence/prognosis …..
-
- May 5, 2013 at 12:56 pm
I think our next step is to find a good melanoma specialist. This is all so new to us. I still don’t understand what the ramifications are regarding the residual melanoma in situ. Will it grow into another nodular melanoma? What kind of surgery would he need? He just finished six months of tough chemo for a rare lymphoma he’s been dealing with for 13 years. Needless to say he is pretty upset knowing he may have to have more surgery. Tough decisions are ahead. -
- May 5, 2013 at 2:39 am
Thanks for posting the whole report, it just helps to make sure we have the whole picture when trying to comment. So, are there any plans to do more surgery or are you going to leave things as-is?
Good news for catching a nodular lesion so early.
Best wishes,
Janner
-
- May 4, 2013 at 11:58 pm
Janner,
Thank you for your response. I’ll try to be more precise. My husband had a lesion on his cheek removed in march. The dermatologist did a shave biopsy. The path report came back as nodular melanoma. It was .95mm in depth. The dermatologist found us a surgeon. We went to the surgeon and because the lesion was so close to his mouth he told us we would need a plastic surgeon. When the surgeon came out of surgery he told me the plastic surgeon did the wide excision before he did the SLNB which I knew,from reading about the surgery was not the proper protocol. Anyway below is the path report.
Final diagnosis:
A. Excision right cheek lesion:
Residual melanoma in situ in a background of cicatrix
Melanoma in situ measures o.4 cm (4mm) in horizontal dimension and lies 0.4 cm from the nearest epidermal edge of resection (6:00-9:00)
All surgical margins negative for melanoma
No evidence of residual invasive melanoma.
B: Cervical sentinel lymph node:
Single lymph node negative for metastatic melanomaComments:
There is residual melanoma in situ within the previous biopsy area highlighted on a melanoma A immunostaining. There is no residual vertical component. The separately submitted sentinel node is negative for malignancy (H&E, Melanoma A and HMB45 immunostaining.)There is then information on the staging study which is 1b.
Ancillary studies:
Immunohistochemisty;
Material: Block A3
Population: Tumor cells
Antibody Result
MART-1 (MELAN A) red chomogen. PositiveSorry for such a lengthy note.
Arlene
-
- May 4, 2013 at 11:58 pm
Janner,
Thank you for your response. I’ll try to be more precise. My husband had a lesion on his cheek removed in march. The dermatologist did a shave biopsy. The path report came back as nodular melanoma. It was .95mm in depth. The dermatologist found us a surgeon. We went to the surgeon and because the lesion was so close to his mouth he told us we would need a plastic surgeon. When the surgeon came out of surgery he told me the plastic surgeon did the wide excision before he did the SLNB which I knew,from reading about the surgery was not the proper protocol. Anyway below is the path report.
Final diagnosis:
A. Excision right cheek lesion:
Residual melanoma in situ in a background of cicatrix
Melanoma in situ measures o.4 cm (4mm) in horizontal dimension and lies 0.4 cm from the nearest epidermal edge of resection (6:00-9:00)
All surgical margins negative for melanoma
No evidence of residual invasive melanoma.
B: Cervical sentinel lymph node:
Single lymph node negative for metastatic melanomaComments:
There is residual melanoma in situ within the previous biopsy area highlighted on a melanoma A immunostaining. There is no residual vertical component. The separately submitted sentinel node is negative for malignancy (H&E, Melanoma A and HMB45 immunostaining.)There is then information on the staging study which is 1b.
Ancillary studies:
Immunohistochemisty;
Material: Block A3
Population: Tumor cells
Antibody Result
MART-1 (MELAN A) red chomogen. PositiveSorry for such a lengthy note.
Arlene
-
- May 4, 2013 at 10:07 pm
It's typically more helpful when you can post the entire report as opposed to bits and pieces. But basically, it means that while they didn't find any residual melanoma deep in the lesion, they found some on the surface in the scar tissue from the biopsy. Basically, the original biopsy wasn't wide enough to remove all the melanoma in situ at the surface, but did manage to get the complete depth. Was this a punch biopsy? Are they planning to do another excision? In general, you want at least 5mm of clear margins from in situ. While this is close, depending on the depth of the lesion, I might consider having more taken. Since the SNB is negative, I'd probably be of the thought that surgery is still the best weapon against early melanoma and I'd probably be pretty aggressive trying to remove any remaining cells.
Best wishes,
Janner
-
- May 4, 2013 at 10:07 pm
It's typically more helpful when you can post the entire report as opposed to bits and pieces. But basically, it means that while they didn't find any residual melanoma deep in the lesion, they found some on the surface in the scar tissue from the biopsy. Basically, the original biopsy wasn't wide enough to remove all the melanoma in situ at the surface, but did manage to get the complete depth. Was this a punch biopsy? Are they planning to do another excision? In general, you want at least 5mm of clear margins from in situ. While this is close, depending on the depth of the lesion, I might consider having more taken. Since the SNB is negative, I'd probably be of the thought that surgery is still the best weapon against early melanoma and I'd probably be pretty aggressive trying to remove any remaining cells.
Best wishes,
Janner
-
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