Path Report
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Path Report

› Forums › Cutaneous Melanoma Community › Path Report

  • Post
    • February 21, 2018 at 6:40 pm
    tedtell1
    Participant

    Folks, here is my path report. FYI, a PET scan and Brain MRI were all clear, I guess my question is, do I really need to go through a year with NIVO every two weeks since the cancer hasn't spread, or even the surgery for that matter? 

    Thoughts?

     

    NOTE)
    Surgical Final Report
    Patient Name: TELLMAN, THEODORE R
    Accession #:S18-4295
    Taken: 1/31/2018
    Received: 1/31/2018
    Reported: 2/7/2018
    Physician(s): DEVI K CHETTIAR

    Final Pathologic Diagnosis
    Skin, left upper back, excision:
    1. Dermal melanoma
    2. Tumor extends to a peripheral margin and to within 0.1 mm of
    the deep margin
    3. See comment
    Comments
    The lesion is centered deeply in the dermis and the findings are most
    supportive of metastatic melanoma. Correlation with clinical findings
    and imaging studies is recommended. Dr. Warren Goodman has seen this
    case and agrees with the interpretation. Devi Chettiar, PA was
    notified via telephone conversation on 2/6/18 at 3 pm.
    *Electronically Signed Out By*
    Katherine E. Brick, MD
    Procedures/Addenda
    Clinical History
    Cyst
    Gross Description
    The specimen is received in formalin and labeled with the patient's
    name and "left upper back". The speci
    men consists of a 2 x 1.3 x 1.2
    cm portion of tan-yellow fibrofatty tissue with an attached 2 x 0.6 cm
    tan-pink skin ellipse. No orientation is provided and the external
    surface is inked green. Sectioning reveals firm pale tan centrally
    incised cut surfaces throughout and abutting the margin. The specimen
    is entirely submitted in six cassettes.
    1. Representative sections
    2. Ellipse tips
    3-6. Remainder of specimen. cl
    cll/1/31/2018
    Microscopic Description
    Histologic sections of skin on six (6) H&E slides from six blocks
    are reviewed. There is a dermally based tumor located deep within the
    dermis and extending up to the subcutis. There are multiple cohesive
    nodules composed of cells with pale cytoplasm, enlarged nuclei,
    prominent nucleoli, and abundant mitotic activity. The nodules display
    areas of central necrosis and form a mass encompassing the mid to deep
    dermis. Immunostains show that these cells are positive for S100,
    SOX-10, and Viment
    in, and negative for CD34, cytokeratin Oscar,
    cytokeratin AE1/AE3, Melan-A, and EMA. The tumor extends to a
    peripheral margin and to within 0.1 mm of the deep margin.
    keb/2/7/2018
    Katherine E. Brick, MD
    Regions Hospital
    Department of Pathology
    640 Jackson Street
    St. Paul, MN 55101  

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  • Replies
      • February 22, 2018 at 1:50 am
      Bubbles
      Participant

      The fact that your path report says:   "findings are most supportive of metastatic melanoma" says it all.  You have metastatic melanoma.  This shit don't play.  The fact that you have adjuvant therapy as an option is beyond the hopes and dreams of patients with metastatic melanoma just a few years ago!  Go for it. You have a chance to escape melanoma neverland.  Take it!  celeste

        • February 22, 2018 at 12:30 pm
        tedtell1
        Participant

        Thanks for telling my like it is…I guess I need that.

        T

      • February 22, 2018 at 2:07 pm
      TexMelanomex
      Participant

      Ted,

      Gather your battle gear and go on the full offensive. Completely agree with Celeste, its no joke but there are many effective tools for taking the fight to the enemy. Everyone is different but I'm having great results with Keytruda and was fortunate enough to be involved in a clinical trial at MD Anderson. We live in a time when there are actually options for fighting and beating this, which is much different that even a few years ago. Arm yourself with knowledge and a solid treatment team (melanoma specialists) and beat the hell out of this!

      Tex

      • February 22, 2018 at 2:12 pm
      Janner
      Participant

      Just adding for additional understanding – scans only have so much resolution.  PET scan is usually around 5mm.  So you don't have a 5mm tumor or larger via the PET scan, but that doesn't mean you don't have cells floating around.  Scans won't find small amounts of melanoma.  Scans won't tell you if there are additional cells around your biopsy site that are still there.  And scans haven't told you where the melanoma originated.  Scans are helpful to a point but they don't tell the entire story. 

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