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Ok to watch a possible Spitz Nevus without biopsy?

Forums Cutaneous Melanoma Community Ok to watch a possible Spitz Nevus without biopsy?

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      Just home from a new dermatologist. My 6yo daughter has had a round, red bump on her upper arm for about 2.5 years. Up until this point, our pediatrician had just been keeping an eye on it without giving it too much thought. 

      We moved six months ago and I sort of forgot about it and hadn’t been to the new dr as we are between annual visits. I started researching melanoma after concern about a mole of my own and stumbled upon Spitz nevus and it’s similarity to melanoma. Looked at it again and it’s definitely bigger than it was a year ago, but she’s also grown a lot this year and gained some weight so it almost just looks like it’s grown with her accordingly. It’s about 1cm now, no assymetry. 

      Panicked anyway and took her into the pediatrician. She was content to just watch it but I pushed for an urgent derm appointment. The dermatologist said it looked like a pink/red mole or possibly a Spitz nevus. It’s not irritated, oozy, itchy, or asymmetrical, so she said she was more than comfortable measuring and checking again in 3 months. She said she would be shocked if it was melanoma. She said we could biopsy but didn’t think it was necessary right now and if it did come back as spitz, we’d be looking at having to go back in again to remove the rest. 

      Anyone have any experience or thoughts? Do you think it’s safe to just watch and wait right now or should I go back and push for the biopsy?

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          If it were my child I’d have it biopsied, if for no other reason than peace of mind. My primary was skin colored,raised, small, symmetrical, no irritation. Just telling you that because it did not fit the typical description and the derm thought it was benign but I insisted on a biopsy. However it appeared pretty suddenly, unlike your daughter’s. I’m sorry you have to worry about this!!

              So, after the appointment I was able to obtain her previous records. A year and a half ago it was 6mm x 7mm, and now it’s 9mm x 10mm. She has grown quite a bit since then, however, gained about 18 lbs, so it may just be the skin stretching and normal proportional mole growth? I reported this to the derm and she said we’ll go ahead and do the biopsy tomorrow and send it in. 

              Can someone please talk me down?? I’m so sick with worry. I’m 22 wks pregnant with my fourth and cannot calm down or sleep. I’m overwhelmed. I’ve convinced myself that this is mestastic melanoma because we waited 3 years. How irrational am I being?? frown


                Since it is grown and is quite big now (1 cm is not a small lesion), I would remove it for a piece of mind. Maybe it would be worth to let a plastic surgeon to do it: it will be cosmetically better and the whole lesion would be gone. 1 cm is too big for a punch biopsy, while shave biopsy may not remove the whole thing. Best of luck!

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