- September 1, 2018 at 5:36 pm
About a month ago I had a shave biopsy done on a spot that I had had for over 10 yrs but had slowly grown. I had 4 different dermatologists tell me it was just a sun spot and that I shouldn’t be concerned. About a year ago the same spot developed a VERY small, flat freckle within it. Again the derms told me it was just a sun spot. Last mo th I finally demanded it be removed as and t never sat well with me. My mother died of melanoma when I was 4 yrs old and I don’t like to mess around. The original pathology came back as “atypical melanocytic neoplasm confined to the epidermis” but didn’t have clean margins. Two weeks ago they took more tissue in an excision and reassured me that this was NOT a melanoma and that we had caught it very early before it could become a melanoma. I got pathology back on that excision a few day ago and it seems it is all n fact a melanoma. My doc says it’s insitu and will be cured with one final excision since it still extended to the margins in one area. I am so scared it’s worse than they think since it was the first time. Please help me to decipher my pathology report.
Dianosis: Residual Melanoma In Situ- extending to the peripheral margin between 6 and 9 o’clock.
Microscopic Description: Apel rod, poorly circumscribed proliferation of a typical melanocytes is present along the dermal – epidermal junction. Solitary melanocytes predominate over the formation of irregular nests. Zones of confluence of melanocytes along the basal cell layer present. Melanocytes also migrate in haphazard fashion throughout the thickness of the Epithelium.
How bad does this sound to everyone? The spot was completely flat and not itchy or bleeding at all.
- September 2, 2018 at 7:04 am
As far as melanoma goes, this is the jackpot: in situ has no metastatic potential/no means of spreading, and the big danger with melanoma is not what is excised but what has already spread through blood and lymph. As far as skin cancer goes, melanoma is certainly NOT the jackpot because of its potential to metastasise, so that's a bummer to have it at all, but if you do have it then in situ is the best kind of all. Once you have the wide level excision done, you should just have regular skin checks and NEVER accept a shave biopsy for a suspected melanoma because they can be incomplete (like yours, with residual melanoma left behind. Always get a proper excisional biopsy for suspected melanoma. But how bad does it sound? Not. Bad. At. All. The only better scenario was for it to be one of the more benign types of skin cancer like BCC or SCC, or better still not skin cancer at all.
- September 3, 2018 at 12:09 am
Thank you. I know that I have a better report than most on this forum and I am not ungrateful for that. I’m just scared. I lost my mother at 4 yrs old to this beast and she was only 2 yrs older than I am now. I’m a mom and a wife and I don’t want to have the same fate as she did. I’ve spent a lot of time crying these last few days.
- September 3, 2018 at 3:18 am
Just as a reassurance I had melanoma in situ 44 years ago and, though I've had many moles/spots biopsied, have not had any further problems. My daughter, however, has stage 3b melanoma (5 yrs. NED). I am surprised that with your family history your doctors made you wait so long for a simple biopsy. I've had some moles removed just because they were in areas that were irritating under clothes or prone to be scratched. Please make your doctors listen to you in the future or find new doctors. It's easy for them to say it is nothing but it is your life.
- September 3, 2018 at 2:29 pm
Thank you for that reassurance. During the year and a half I was worried about this particular spot, I had a few other removed at request of my dermatologist. Those all came back as mildly atypical. The spot that ended up being a melanoma looked so much like a sun spot… the ONLY reason it started to bother me is because it developed the TINIEST darker brown freckle inside of it. Goes to show me have to follow our guts!
- September 3, 2018 at 2:31 pm
If you have to get melanoma, in situ rocks. (My husband – 3C.)
And hat’s off to the OP for fighting for what she needed. I’m not surprised about her doctors. The bell shaped curve exists in every field. Humans make mistakes. We must advocate for ourselves and those we care about. I won’t list the number of mistakes and misdiagnoses that happened just in my own family. Even good docs mess up. My mother’s doctor had the grace to go to her hospital bed at Hopkins although his practice was in DC, and he wept because of what he missed.
MelanomaMikeParticipantThere there, im so sorry about your Mom, not knowing your age (are you 34? 35?) If so, back when you where 4yrs old, treatment for your mom was still up in the air for Melanoma. As far as your situation, just keep up the visits like your doing & stay close to our wonderful MRF (MPIP) site we have here, unlike me, theres folks with GREAT knowledge of the desease…Mike
- September 3, 2018 at 5:29 pm
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