› Forums › General Melanoma Community › Severely Atypical Actually Melanoma
- This topic has 6 replies, 2 voices, and was last updated 10 years, 10 months ago by
Raoulduke212.
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- May 20, 2015 at 7:51 pm
Hi I recently had a "severely atypical" mole excised from my neck. I read a paper that says these sometimes are diagnosed as actually melanoma after the full excision is biopsied. This thing has been on my neck for at least 1.5 years, and I'm kind of freaked out that it is actually melanoma. Can I generally rely on the original pathology report that called this "severely atyipcal?" How generally common is it for these severely atyipcal moles to actually be misdiagnosed melanomas?
Thanks,
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- May 20, 2015 at 8:34 pm
In general, lesions are "over-diagnosed" versus "under-diagnosed". They are diagnosing more melanoma in situ than they used to – not the other way around. Over diagnosing means the pathologist is covered (read CYA). Biopsies tend to remove the majority – if not all of the entire lesion. Biopsy material is analyzed more closely than the wide excision tissue. So it is rare that any wide excision would actually change a diagnosis unless the biopsy was of a very small portion of the lesion. (Partial biopsies are discouraged unless it really make sense say for cosmetic reasons). Wide excision tissue just doesn't have much (if any) of the tumor to analyze – MARGINS are the important consideration for the wide excision.
Did a dermatopathologist read your slides? It is someone who sees a lot of melanoma? If so, then I think you relax and not read into anything about your lesion. Yes, if you want to, you can send your slides to another pathologist. Most major labs actually have more than one pathologist confer on the final diagnosis now, so it may already have been looked at by multiple eyes.
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- May 20, 2015 at 9:05 pm
Thank you so much that makes me feel so much better. I'm not sure if the pathologist was a dermopathologist but i would imagine they see a lot of melanoma because I'm in LA and my doctor is part of UCLA and I know they are a very busy office so i'm sure just based on the number of patients they have, they are well experiened in diagnosing melanoma.
My doctor also said that there is some discretion between diagnosing a "severely" vs. a "moderately" atypical mole, but not really so when it comes to melanoma.
Anyway, thanks again.
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- May 20, 2015 at 9:05 pm
Thank you so much that makes me feel so much better. I'm not sure if the pathologist was a dermopathologist but i would imagine they see a lot of melanoma because I'm in LA and my doctor is part of UCLA and I know they are a very busy office so i'm sure just based on the number of patients they have, they are well experiened in diagnosing melanoma.
My doctor also said that there is some discretion between diagnosing a "severely" vs. a "moderately" atypical mole, but not really so when it comes to melanoma.
Anyway, thanks again.
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- May 20, 2015 at 9:05 pm
Thank you so much that makes me feel so much better. I'm not sure if the pathologist was a dermopathologist but i would imagine they see a lot of melanoma because I'm in LA and my doctor is part of UCLA and I know they are a very busy office so i'm sure just based on the number of patients they have, they are well experiened in diagnosing melanoma.
My doctor also said that there is some discretion between diagnosing a "severely" vs. a "moderately" atypical mole, but not really so when it comes to melanoma.
Anyway, thanks again.
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- May 20, 2015 at 8:34 pm
In general, lesions are "over-diagnosed" versus "under-diagnosed". They are diagnosing more melanoma in situ than they used to – not the other way around. Over diagnosing means the pathologist is covered (read CYA). Biopsies tend to remove the majority – if not all of the entire lesion. Biopsy material is analyzed more closely than the wide excision tissue. So it is rare that any wide excision would actually change a diagnosis unless the biopsy was of a very small portion of the lesion. (Partial biopsies are discouraged unless it really make sense say for cosmetic reasons). Wide excision tissue just doesn't have much (if any) of the tumor to analyze – MARGINS are the important consideration for the wide excision.
Did a dermatopathologist read your slides? It is someone who sees a lot of melanoma? If so, then I think you relax and not read into anything about your lesion. Yes, if you want to, you can send your slides to another pathologist. Most major labs actually have more than one pathologist confer on the final diagnosis now, so it may already have been looked at by multiple eyes.
-
- May 20, 2015 at 8:34 pm
In general, lesions are "over-diagnosed" versus "under-diagnosed". They are diagnosing more melanoma in situ than they used to – not the other way around. Over diagnosing means the pathologist is covered (read CYA). Biopsies tend to remove the majority – if not all of the entire lesion. Biopsy material is analyzed more closely than the wide excision tissue. So it is rare that any wide excision would actually change a diagnosis unless the biopsy was of a very small portion of the lesion. (Partial biopsies are discouraged unless it really make sense say for cosmetic reasons). Wide excision tissue just doesn't have much (if any) of the tumor to analyze – MARGINS are the important consideration for the wide excision.
Did a dermatopathologist read your slides? It is someone who sees a lot of melanoma? If so, then I think you relax and not read into anything about your lesion. Yes, if you want to, you can send your slides to another pathologist. Most major labs actually have more than one pathologist confer on the final diagnosis now, so it may already have been looked at by multiple eyes.
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Tagged: cutaneous melanoma
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