› Forums › General Melanoma Community › Newly Diagnosed-Melanoma in Situ
- This topic has 39 replies, 6 voices, and was last updated 7 years, 4 months ago by
Kenkussions.
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- December 22, 2016 at 8:26 pm
Hello everyone,
I was just diagnosed (12/19/2016) with Melanoma In Situ on my neck. I have a family history of skin cancer (both my father and grandfather) however, I have found out that all of theirs came back as BCC or SCC not melanoma. I go in for a WLE on 12/27/2016 and am fairly nervous as I know I will be awake and the spot they are removing is right behind my ear (I feel like I will hear everything being cut/ cottarized. Apparently they will leave the wound open for 2 days for testing then if all clear margins I go back in Thursday 12/29/2016 to get sewn up/ more removed if not clear. Those two days do not sound very fun but after researching online and on this forum I realize I just have to get it done. I now know that the "in Situ" is the best possible diagnosis if melanoma is present but I am very fearful that there may be more on my body that we are not finding. Below is what the pathology report came back as any insights would be appreciated. I am just scarring myself reading all of these stories of how often melanoma tends to come back with a vengeance.
Diagnosis:
Left occipital scalp-
Melanoma in Situ
Note: There are features of a dysplastic nevus as well. Pathologic stage: pTis.
Clinical Data:
Dysplastic Nevus
Gross Description:
Received in formalin labeled with patient's name is a tan shave biopsy measuring 7mm x 7mm x 1mm. Specimen submitted in 1 cassette, 2 pieces.
Microscopic Description:
There is a proliferation of atypical melanocytes present in the epidermis with irregular nests of melanocytes aggregated at the dermoepidermal juntion and solitary melanocytes present within the epidermis. The process is confined to the epidermis. These changes represent primary malignant melanoma in situ.
- Replies
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- December 22, 2016 at 9:05 pm
Hi,
It has been said before on this board- the overwhelmng majority of folk with in situ get it treated and move on with their lives. It is those of us who are the tiny minority who progress after a T1a diagnosis and treatment who remain active or lurking on the boards as we struggle to find the best treatment following progression.
Your path report is reassuring and the excision will put the matter to bed. Yes, stay vigilant and attend check ups and use you sunscreen but that would be wise behaviour regardless. It is a shock– but they caught it early and all will be well..
Best wishes
Deb
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- December 22, 2016 at 9:05 pm
Hi,
It has been said before on this board- the overwhelmng majority of folk with in situ get it treated and move on with their lives. It is those of us who are the tiny minority who progress after a T1a diagnosis and treatment who remain active or lurking on the boards as we struggle to find the best treatment following progression.
Your path report is reassuring and the excision will put the matter to bed. Yes, stay vigilant and attend check ups and use you sunscreen but that would be wise behaviour regardless. It is a shock– but they caught it early and all will be well..
Best wishes
Deb
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- December 22, 2016 at 9:05 pm
Hi,
It has been said before on this board- the overwhelmng majority of folk with in situ get it treated and move on with their lives. It is those of us who are the tiny minority who progress after a T1a diagnosis and treatment who remain active or lurking on the boards as we struggle to find the best treatment following progression.
Your path report is reassuring and the excision will put the matter to bed. Yes, stay vigilant and attend check ups and use you sunscreen but that would be wise behaviour regardless. It is a shock– but they caught it early and all will be well..
Best wishes
Deb
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- December 22, 2016 at 9:25 pm
One of the reasons why in situ is the best one to get if you're gonna get melanoma.. is because it is confined to the epidermis (outer layer of skin) and it has no access to lymph or blood vessels, therefore cannot spread at all. I have had multiple family members get in situ melanoma and 10-20 years later they've never dealt with melanoma again.
The WLE will be the worst part, but once that is over with, life will go on and you'll be aware of any new or changing spots and get them checked out and taken off.
All the best and happy holidays,
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- December 22, 2016 at 10:47 pm
Thank you both for your quick responses. I know after reading so much that at this point I am fortunate to have caught it early (I saw the mole over a year ago and thought it looked a little dark but it was right on my hairline of my neck and I just cut my hair shorter and thought it must have always been there). The thing that prompted me to go get it checked out is I just found out that I have a cousin that is stage 4 melanoma and is not doing well at all. I am not looking forward to next week WLE especially in that area but I know the alternative is worse. Having a 16-month-old daughter has just been making any diagnoses like this very difficult for me. Hopefully, as you two have stated I can get it removed and move on but I will always be wearing sunblock and getting very regular skin checks. One last question (for now ;)) is it normal procedure for my WLE to go as follows:
Day 1: WLE Procedure (leave wound open and unstitched)
Day 2: wait for path reports
Day 3: Visit Dr. to get path reports, if clear margins stitch up if unclear remove more tissue and repeat
From what I have read I thought the WLE would be closed up immediately. I understand why they are doing it, it just sounds like it will be an uncomfortable week. Especially, the local anesthetic to close up the open wound.
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- December 22, 2016 at 11:18 pm
It sounds like this is what you might call a "staged Mohs" procedure. Mohs is often done for the other types of skin cancer. Remove some tissue, immediately analyze it and go back and get more if needed to get clean margins. This is done as a tissue saving technique usually over the course of several hours. Mohs uses "frozen sections" to look at the skin samples which can be prepared quickly. Unfortunately, melanocytes don't show up that well with frozen sections, they do better when prepared with paraffin and stains. So I suspect they are planning to do an initial excision, then process the tissue with paraffin to get the best data. Then if they don't have the margins they need, they will go back 2 days later to remove the desired margins and stitch you up. Given the location where there isn't a lot of excess skin, they are most likely trying to minimize the removal to the least possible tissue to accomplish the goal. With melanoma, "clean margins" aren't typically considered good enough, you want more taken. Generally, melanoma in situ requires at least 5mm margins. One study reported 9mm was a better choice but you may not have that option here.
My best guess…
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- December 23, 2016 at 12:27 am
I wanted to give you my story. I was in your same place I had stage 1 and it was removed with wide excision. I also have a baby and little girl. It's scary and hard but you've got this early even earlier than myself. I have anxiety already but this has made it worse. Don't let this ruin your days. I had all this done almost a year ago. I have my 3 month visits and everything has been fine. I've tLked with a lot of people and it seems having something like this while young and with pregnancy etc. is fairly more common than I thought. Not saying yours was from pregnancy but you mentioned your toddler. Just try to not think the worst. The Internet can be a good thing but sometimes not. Be aware of course but be happy as well. You have caught this so early and you are lucky.
G
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- December 23, 2016 at 1:19 am
Thank you all for your reassuring replies. I will be sure to follow up with my results. Everyone have a great holiday and best wishes in everyone's journey.
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- December 23, 2016 at 1:19 am
Thank you all for your reassuring replies. I will be sure to follow up with my results. Everyone have a great holiday and best wishes in everyone's journey.
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- December 23, 2016 at 1:19 am
Thank you all for your reassuring replies. I will be sure to follow up with my results. Everyone have a great holiday and best wishes in everyone's journey.
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- December 23, 2016 at 12:27 am
I wanted to give you my story. I was in your same place I had stage 1 and it was removed with wide excision. I also have a baby and little girl. It's scary and hard but you've got this early even earlier than myself. I have anxiety already but this has made it worse. Don't let this ruin your days. I had all this done almost a year ago. I have my 3 month visits and everything has been fine. I've tLked with a lot of people and it seems having something like this while young and with pregnancy etc. is fairly more common than I thought. Not saying yours was from pregnancy but you mentioned your toddler. Just try to not think the worst. The Internet can be a good thing but sometimes not. Be aware of course but be happy as well. You have caught this so early and you are lucky.
G
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- December 23, 2016 at 12:27 am
I wanted to give you my story. I was in your same place I had stage 1 and it was removed with wide excision. I also have a baby and little girl. It's scary and hard but you've got this early even earlier than myself. I have anxiety already but this has made it worse. Don't let this ruin your days. I had all this done almost a year ago. I have my 3 month visits and everything has been fine. I've tLked with a lot of people and it seems having something like this while young and with pregnancy etc. is fairly more common than I thought. Not saying yours was from pregnancy but you mentioned your toddler. Just try to not think the worst. The Internet can be a good thing but sometimes not. Be aware of course but be happy as well. You have caught this so early and you are lucky.
G
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- December 25, 2016 at 2:57 am
After reading a lot about melanoma diagnosis and path reports I realized mine doesn't talk about a lot of the important issues (Clarks/breslow figures, mitosis, ulceration, whether or not there were clear margins in the initial biopsy, depth etc) any idea why this information is missing the lab that processed my results was a dermotopathology lab so I figure they would include this seemingly important information. Also, would it be a good idea after my wle results come back to have my initial biopsy and wle results sent to another lab for a second opinion/confirmation? Appreciate any insights and merry Christmas/happy holidays to everyone.
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- December 25, 2016 at 2:57 am
After reading a lot about melanoma diagnosis and path reports I realized mine doesn't talk about a lot of the important issues (Clarks/breslow figures, mitosis, ulceration, whether or not there were clear margins in the initial biopsy, depth etc) any idea why this information is missing the lab that processed my results was a dermotopathology lab so I figure they would include this seemingly important information. Also, would it be a good idea after my wle results come back to have my initial biopsy and wle results sent to another lab for a second opinion/confirmation? Appreciate any insights and merry Christmas/happy holidays to everyone.
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- December 25, 2016 at 2:57 am
After reading a lot about melanoma diagnosis and path reports I realized mine doesn't talk about a lot of the important issues (Clarks/breslow figures, mitosis, ulceration, whether or not there were clear margins in the initial biopsy, depth etc) any idea why this information is missing the lab that processed my results was a dermotopathology lab so I figure they would include this seemingly important information. Also, would it be a good idea after my wle results come back to have my initial biopsy and wle results sent to another lab for a second opinion/confirmation? Appreciate any insights and merry Christmas/happy holidays to everyone.
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- December 25, 2016 at 6:29 am
In situ reports are much less involved because in situ has no depth, no mitosis, doesn't deal with any of the other things that would get mentioned in a report involving a lesion with depth that goes into the deeper layers of skin.
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- December 25, 2016 at 6:29 am
In situ reports are much less involved because in situ has no depth, no mitosis, doesn't deal with any of the other things that would get mentioned in a report involving a lesion with depth that goes into the deeper layers of skin.
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- December 25, 2016 at 10:41 pm
Thanks for the response. What do you all think of me having my initial biopsy as well as my wle slides (after they are taken on Tuesday) sent to another pathologist for a second reading of both interpretations… Worth it or not? The current pathology lab that read my initial slides was Cockrell dermotapathology
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- December 25, 2016 at 10:41 pm
Thanks for the response. What do you all think of me having my initial biopsy as well as my wle slides (after they are taken on Tuesday) sent to another pathologist for a second reading of both interpretations… Worth it or not? The current pathology lab that read my initial slides was Cockrell dermotapathology
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- December 26, 2016 at 5:26 am
If a dermatopathologist did this pathology, then there wouldn't be much need to send it elsewhere. It won't say anything different. If it was something deeper with suspicious parts in the report, then maybe. But, this is pretty straight forward.
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- December 26, 2016 at 5:26 am
If a dermatopathologist did this pathology, then there wouldn't be much need to send it elsewhere. It won't say anything different. If it was something deeper with suspicious parts in the report, then maybe. But, this is pretty straight forward.
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- December 26, 2016 at 5:26 am
If a dermatopathologist did this pathology, then there wouldn't be much need to send it elsewhere. It won't say anything different. If it was something deeper with suspicious parts in the report, then maybe. But, this is pretty straight forward.
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- December 25, 2016 at 10:41 pm
Thanks for the response. What do you all think of me having my initial biopsy as well as my wle slides (after they are taken on Tuesday) sent to another pathologist for a second reading of both interpretations… Worth it or not? The current pathology lab that read my initial slides was Cockrell dermotapathology
-
- December 25, 2016 at 6:29 am
In situ reports are much less involved because in situ has no depth, no mitosis, doesn't deal with any of the other things that would get mentioned in a report involving a lesion with depth that goes into the deeper layers of skin.
-
- December 22, 2016 at 11:18 pm
It sounds like this is what you might call a "staged Mohs" procedure. Mohs is often done for the other types of skin cancer. Remove some tissue, immediately analyze it and go back and get more if needed to get clean margins. This is done as a tissue saving technique usually over the course of several hours. Mohs uses "frozen sections" to look at the skin samples which can be prepared quickly. Unfortunately, melanocytes don't show up that well with frozen sections, they do better when prepared with paraffin and stains. So I suspect they are planning to do an initial excision, then process the tissue with paraffin to get the best data. Then if they don't have the margins they need, they will go back 2 days later to remove the desired margins and stitch you up. Given the location where there isn't a lot of excess skin, they are most likely trying to minimize the removal to the least possible tissue to accomplish the goal. With melanoma, "clean margins" aren't typically considered good enough, you want more taken. Generally, melanoma in situ requires at least 5mm margins. One study reported 9mm was a better choice but you may not have that option here.
My best guess…
-
- December 22, 2016 at 11:18 pm
It sounds like this is what you might call a "staged Mohs" procedure. Mohs is often done for the other types of skin cancer. Remove some tissue, immediately analyze it and go back and get more if needed to get clean margins. This is done as a tissue saving technique usually over the course of several hours. Mohs uses "frozen sections" to look at the skin samples which can be prepared quickly. Unfortunately, melanocytes don't show up that well with frozen sections, they do better when prepared with paraffin and stains. So I suspect they are planning to do an initial excision, then process the tissue with paraffin to get the best data. Then if they don't have the margins they need, they will go back 2 days later to remove the desired margins and stitch you up. Given the location where there isn't a lot of excess skin, they are most likely trying to minimize the removal to the least possible tissue to accomplish the goal. With melanoma, "clean margins" aren't typically considered good enough, you want more taken. Generally, melanoma in situ requires at least 5mm margins. One study reported 9mm was a better choice but you may not have that option here.
My best guess…
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- December 22, 2016 at 10:47 pm
Thank you both for your quick responses. I know after reading so much that at this point I am fortunate to have caught it early (I saw the mole over a year ago and thought it looked a little dark but it was right on my hairline of my neck and I just cut my hair shorter and thought it must have always been there). The thing that prompted me to go get it checked out is I just found out that I have a cousin that is stage 4 melanoma and is not doing well at all. I am not looking forward to next week WLE especially in that area but I know the alternative is worse. Having a 16-month-old daughter has just been making any diagnoses like this very difficult for me. Hopefully, as you two have stated I can get it removed and move on but I will always be wearing sunblock and getting very regular skin checks. One last question (for now ;)) is it normal procedure for my WLE to go as follows:
Day 1: WLE Procedure (leave wound open and unstitched)
Day 2: wait for path reports
Day 3: Visit Dr. to get path reports, if clear margins stitch up if unclear remove more tissue and repeat
From what I have read I thought the WLE would be closed up immediately. I understand why they are doing it, it just sounds like it will be an uncomfortable week. Especially, the local anesthetic to close up the open wound.
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- December 22, 2016 at 10:47 pm
Thank you both for your quick responses. I know after reading so much that at this point I am fortunate to have caught it early (I saw the mole over a year ago and thought it looked a little dark but it was right on my hairline of my neck and I just cut my hair shorter and thought it must have always been there). The thing that prompted me to go get it checked out is I just found out that I have a cousin that is stage 4 melanoma and is not doing well at all. I am not looking forward to next week WLE especially in that area but I know the alternative is worse. Having a 16-month-old daughter has just been making any diagnoses like this very difficult for me. Hopefully, as you two have stated I can get it removed and move on but I will always be wearing sunblock and getting very regular skin checks. One last question (for now ;)) is it normal procedure for my WLE to go as follows:
Day 1: WLE Procedure (leave wound open and unstitched)
Day 2: wait for path reports
Day 3: Visit Dr. to get path reports, if clear margins stitch up if unclear remove more tissue and repeat
From what I have read I thought the WLE would be closed up immediately. I understand why they are doing it, it just sounds like it will be an uncomfortable week. Especially, the local anesthetic to close up the open wound.
-
- December 22, 2016 at 9:25 pm
One of the reasons why in situ is the best one to get if you're gonna get melanoma.. is because it is confined to the epidermis (outer layer of skin) and it has no access to lymph or blood vessels, therefore cannot spread at all. I have had multiple family members get in situ melanoma and 10-20 years later they've never dealt with melanoma again.
The WLE will be the worst part, but once that is over with, life will go on and you'll be aware of any new or changing spots and get them checked out and taken off.
All the best and happy holidays,
-
- December 22, 2016 at 9:25 pm
One of the reasons why in situ is the best one to get if you're gonna get melanoma.. is because it is confined to the epidermis (outer layer of skin) and it has no access to lymph or blood vessels, therefore cannot spread at all. I have had multiple family members get in situ melanoma and 10-20 years later they've never dealt with melanoma again.
The WLE will be the worst part, but once that is over with, life will go on and you'll be aware of any new or changing spots and get them checked out and taken off.
All the best and happy holidays,
-
- December 23, 2016 at 3:00 am
Hi:) I am sorry about your recent diagnosis. I also found this site because I too, just had an melanoma in situ removed. My WLE was a week ago. I can completed understand your worries me concerns–again, this is how I found this site!
Getting any cancer diagnosis is scary–even if caught early–it drastically changes things in an instant. As stated above I would take this as a wake up call and remain vigilant with skin checks and dr appts. I wish you luck with your procedure-I am also curious how they are doing your WLE or mohs procedure. Please let us know how you are-and if you ever need friend I am here for you! Good luck:)
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- December 23, 2016 at 3:00 am
Hi:) I am sorry about your recent diagnosis. I also found this site because I too, just had an melanoma in situ removed. My WLE was a week ago. I can completed understand your worries me concerns–again, this is how I found this site!
Getting any cancer diagnosis is scary–even if caught early–it drastically changes things in an instant. As stated above I would take this as a wake up call and remain vigilant with skin checks and dr appts. I wish you luck with your procedure-I am also curious how they are doing your WLE or mohs procedure. Please let us know how you are-and if you ever need friend I am here for you! Good luck:)
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- December 23, 2016 at 3:00 am
Hi:) I am sorry about your recent diagnosis. I also found this site because I too, just had an melanoma in situ removed. My WLE was a week ago. I can completed understand your worries me concerns–again, this is how I found this site!
Getting any cancer diagnosis is scary–even if caught early–it drastically changes things in an instant. As stated above I would take this as a wake up call and remain vigilant with skin checks and dr appts. I wish you luck with your procedure-I am also curious how they are doing your WLE or mohs procedure. Please let us know how you are-and if you ever need friend I am here for you! Good luck:)
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- December 27, 2016 at 8:39 pm
WLE was just finished about an hour ago. Still numb so all is well for now. Go back Thursday to get path results to determine if they need to remove more or can stitch it up (left the wound open for now with a giant bandage covering it). I have sufficiently freaked myself out over the last week (the internet is great for that) but am hoping I am lucky enough to have this be a big wakeup call for me to start actually wearing sunblock and getting regular skin checks as I've never had one to this point. Hope everyone had a great holiday.
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- December 27, 2016 at 8:39 pm
WLE was just finished about an hour ago. Still numb so all is well for now. Go back Thursday to get path results to determine if they need to remove more or can stitch it up (left the wound open for now with a giant bandage covering it). I have sufficiently freaked myself out over the last week (the internet is great for that) but am hoping I am lucky enough to have this be a big wakeup call for me to start actually wearing sunblock and getting regular skin checks as I've never had one to this point. Hope everyone had a great holiday.
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- December 29, 2016 at 8:46 pm
Just got back from the Dr. the path report states that the WLE specimen showed no signs of malignancy. I'm guessing that means everything was taken out with the initial deep biopsy. Got the WLE wound site stitched up closed and I am hoping this will be my last run-in with melanoma. I appreciate the support I received so quickly and know that I am lucky to have caught this very early. I go in next week for a full skin exam as I have a few more suspicious looking moles (hopefully they come back negative). I wish everyone the best with your journey and hope you have a wonderful 2017.
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- December 29, 2016 at 8:46 pm
Just got back from the Dr. the path report states that the WLE specimen showed no signs of malignancy. I'm guessing that means everything was taken out with the initial deep biopsy. Got the WLE wound site stitched up closed and I am hoping this will be my last run-in with melanoma. I appreciate the support I received so quickly and know that I am lucky to have caught this very early. I go in next week for a full skin exam as I have a few more suspicious looking moles (hopefully they come back negative). I wish everyone the best with your journey and hope you have a wonderful 2017.
-
- December 29, 2016 at 8:46 pm
Just got back from the Dr. the path report states that the WLE specimen showed no signs of malignancy. I'm guessing that means everything was taken out with the initial deep biopsy. Got the WLE wound site stitched up closed and I am hoping this will be my last run-in with melanoma. I appreciate the support I received so quickly and know that I am lucky to have caught this very early. I go in next week for a full skin exam as I have a few more suspicious looking moles (hopefully they come back negative). I wish everyone the best with your journey and hope you have a wonderful 2017.
-
- December 27, 2016 at 8:39 pm
WLE was just finished about an hour ago. Still numb so all is well for now. Go back Thursday to get path results to determine if they need to remove more or can stitch it up (left the wound open for now with a giant bandage covering it). I have sufficiently freaked myself out over the last week (the internet is great for that) but am hoping I am lucky enough to have this be a big wakeup call for me to start actually wearing sunblock and getting regular skin checks as I've never had one to this point. Hope everyone had a great holiday.
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Tagged: cutaneous melanoma
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