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Please help- My 3 month old son’s biopsy results

Forums Pediatric & AYA Melanoma Community Please help- My 3 month old son’s biopsy results

  • Post
    jenniebee922
    Participant

      Hello all,

      Hello all,

      I know few, or none, of the people on this board are doctors, but I do know many of you are familiar with pathology reports and what to be concerned about regarding melanoma. I also have some experience with this since my mother is currently a stage III melanoma fighter, but I am reaching out for some help because I am confused about the results of my infant son's biopsy (he is 3 1/2 months). Needless to say since I am familiar with melanoma and its ugliness through my mom's battle, when my son was born with a pigmented mole (congenital nevus) on his right butt cheek, most people thought it was "cute" but to me it was concerning. The mole was about the size of a dime, highly irregular borders, uniform brown color (then parts darkened) and asymmetrical. 

      The first dermatologist I took him to told me to go to NYU Pediatric Dermatology about it bc of the way it looked. I decided to first consult with my mother's dermatologist since he knew our family history and he seems to have taken all the right steps in helping treat my mom. Upon first look he said "oh no, thats nothing, just an early surface birthmark" …or something to that effect. Somewhat reassured, I left it alone. When my son was about 2 months old, I noticed the mole darkened a bit, slightly, but noticeable and there were 5 "dots" around the top portion of the mole when there previously had been 3. No "ugly" changes, but changes nonetheless. I took him back. My moms derm said lets just take it out to ease my worry, and that hes sure it would be nothing.

      So last week my son underwent a scoop biopsy and  yesterday the doctor's office called saying the doctor wanted us to come in for a follow-up. My heart sank. When I got the the office he said "dont worry, I know you're worried its melanoma.. Its definitely not melanoma. Its not cancer. Nothing to lose sleep over, but it is 'unusual' so we will re-excise to make sure we got it all."  

      Here is the exact pathology report:

      "Description of findings by examination histopathologically: There are two populations of melanocytes within the dermis, one with scant cytoplasm and the other with abundant pale-staining cytoplasm that houses dusty melanin. Some melanocytes appear large with prominent nucleoli.

      Diagnosis: CONGENITAL MELANOCYTIC NEVUS WITH COMBINED FEATURES, UNUSUAL. The nest of melanocytes vary in size and shape within the epidermis and upper dermis. Some melanocytes have pleomorphic and prominent nucleoli. The lesion extends to the peripheral margins and focally to the base of the specimen, This lesion should be excised to ensure its complete removal. However, if this is part of a giant congenital nevus, periodic follow-up is highly recommended. The sections have been reviewed by more pathologists as an interdepartmental consultation."

      Help?? I have been researching on the internet and it seems by the terms they used such as "prominent nucleoli" that this mole was severely atypical. They never used mild, moderate or severe atypia to describe the mole, which I thought was the general way to diagnose aytpical moles. What do they mean by unusual..have they not seen this before? why did it require an interdepartmental consultation? could it be something else? Unusual just does not seem very scientific. After leaving the office I wasnt too nervous, but now thinking its severely atypical I have grown a lot more concerned about it. I have now called to try to make that appointment with ped. derm. at NYU and are waiting for their response. We also have a consult appt with a plastic surgeon who will do the second excision.

      Does anyone have any insight on this? Is it "definitely not melanoma"? and if it is "completely removed" does that still elevate my son's risk of developing melanoma in his lifetime? I am so sick over the thought of my poor little baby ever having to suffer, especially with this. Thank you for reading, I know this is long. Any opinions greatly appreciated.

    Viewing 5 reply threads
    • Replies
        Janner
        Participant

          First off, deciphering every line of a pathology report is not constructive.  Those details are justifications for the final diagnosis – and the final diagnosis is not melanoma.  I don't think you should try to assume that any text including "prominent nucleoli" means severely atypical or moderate or even mild.  Congenital nevi are their own beast and are different from all the other moles out there.  The key is getting the entire lesion removed.  If you want addition clarification, discuss this with the NYU pediatric doc when you see them.  I would bring the slides from the biopsy with you (or have them sent now) to the NYU ped derm so they can analyze them as well.  A second opinion on the pathology never hurts.  The key is you are getting this taken care of.  Get the mole entirely removed.  You already have a family history of melanoma and that makes you and your son way ahead of the game.  This doesn't mean melanoma is in his future, but all your family should be watchful as a general rule.  It's easy to jump to conclusions and your family history makes this even easier, but take a step back and just get your second opinion and get it removed.  That's the best course of action.  Researching pathology terms on the internet is not going to change your course of action and may give you entirely inaccurate information.  It's best to get the interpretation from someone who knows and works with the pathologists.  As far as the interdepartmental consultation, that's basically standard with most larger labs.  More than one set of eyes sees the sample and concurs or amends the diagnosis. 

          Best wishes,

          Janner

          Janner
          Participant

            First off, deciphering every line of a pathology report is not constructive.  Those details are justifications for the final diagnosis – and the final diagnosis is not melanoma.  I don't think you should try to assume that any text including "prominent nucleoli" means severely atypical or moderate or even mild.  Congenital nevi are their own beast and are different from all the other moles out there.  The key is getting the entire lesion removed.  If you want addition clarification, discuss this with the NYU pediatric doc when you see them.  I would bring the slides from the biopsy with you (or have them sent now) to the NYU ped derm so they can analyze them as well.  A second opinion on the pathology never hurts.  The key is you are getting this taken care of.  Get the mole entirely removed.  You already have a family history of melanoma and that makes you and your son way ahead of the game.  This doesn't mean melanoma is in his future, but all your family should be watchful as a general rule.  It's easy to jump to conclusions and your family history makes this even easier, but take a step back and just get your second opinion and get it removed.  That's the best course of action.  Researching pathology terms on the internet is not going to change your course of action and may give you entirely inaccurate information.  It's best to get the interpretation from someone who knows and works with the pathologists.  As far as the interdepartmental consultation, that's basically standard with most larger labs.  More than one set of eyes sees the sample and concurs or amends the diagnosis. 

            Best wishes,

            Janner

            Janner
            Participant

              First off, deciphering every line of a pathology report is not constructive.  Those details are justifications for the final diagnosis – and the final diagnosis is not melanoma.  I don't think you should try to assume that any text including "prominent nucleoli" means severely atypical or moderate or even mild.  Congenital nevi are their own beast and are different from all the other moles out there.  The key is getting the entire lesion removed.  If you want addition clarification, discuss this with the NYU pediatric doc when you see them.  I would bring the slides from the biopsy with you (or have them sent now) to the NYU ped derm so they can analyze them as well.  A second opinion on the pathology never hurts.  The key is you are getting this taken care of.  Get the mole entirely removed.  You already have a family history of melanoma and that makes you and your son way ahead of the game.  This doesn't mean melanoma is in his future, but all your family should be watchful as a general rule.  It's easy to jump to conclusions and your family history makes this even easier, but take a step back and just get your second opinion and get it removed.  That's the best course of action.  Researching pathology terms on the internet is not going to change your course of action and may give you entirely inaccurate information.  It's best to get the interpretation from someone who knows and works with the pathologists.  As far as the interdepartmental consultation, that's basically standard with most larger labs.  More than one set of eyes sees the sample and concurs or amends the diagnosis. 

              Best wishes,

              Janner

              POW
              Participant

                You're doing everything just right! Good for you!

                The lesion is NOT melanoma. I don't know if someday it would have become melanoma or not, but the question is moot because you are going to have it removed. Taking your son to a pediatric dematologist and getting their opinion on the biopsy slides is very smart, especially for your own peace of mind. Since this is not a melanoma, your son doesn't have any greater chance of developing a melanoma during his lifetime than he had before. The one good thing is that after this scare, you will be extra carefull to teach him about sun protection and self-examinations so he can remain melanoma-free for the rest of his life. Forewarned is forearmed! 

                  jenniebee922
                  Participant

                    Thank you both for your reassurance. This board has just been a wonderful tool for me, first in handling and understanding my mom's diagnosis and now with this scare concerning my son. Thank you so much for your responses and efforts in helping me understand the meaning behind the report. I wish you both the best. Be well. 

                    jenniebee922
                    Participant

                      Thank you both for your reassurance. This board has just been a wonderful tool for me, first in handling and understanding my mom's diagnosis and now with this scare concerning my son. Thank you so much for your responses and efforts in helping me understand the meaning behind the report. I wish you both the best. Be well. 

                      jenniebee922
                      Participant

                        Thank you both for your reassurance. This board has just been a wonderful tool for me, first in handling and understanding my mom's diagnosis and now with this scare concerning my son. Thank you so much for your responses and efforts in helping me understand the meaning behind the report. I wish you both the best. Be well. 

                      POW
                      Participant

                        You're doing everything just right! Good for you!

                        The lesion is NOT melanoma. I don't know if someday it would have become melanoma or not, but the question is moot because you are going to have it removed. Taking your son to a pediatric dematologist and getting their opinion on the biopsy slides is very smart, especially for your own peace of mind. Since this is not a melanoma, your son doesn't have any greater chance of developing a melanoma during his lifetime than he had before. The one good thing is that after this scare, you will be extra carefull to teach him about sun protection and self-examinations so he can remain melanoma-free for the rest of his life. Forewarned is forearmed! 

                        POW
                        Participant

                          You're doing everything just right! Good for you!

                          The lesion is NOT melanoma. I don't know if someday it would have become melanoma or not, but the question is moot because you are going to have it removed. Taking your son to a pediatric dematologist and getting their opinion on the biopsy slides is very smart, especially for your own peace of mind. Since this is not a melanoma, your son doesn't have any greater chance of developing a melanoma during his lifetime than he had before. The one good thing is that after this scare, you will be extra carefull to teach him about sun protection and self-examinations so he can remain melanoma-free for the rest of his life. Forewarned is forearmed! 

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