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Severely atypical nevi

Forums Cutaneous Melanoma Community Severely atypical nevi

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      Hello  – 

      I have  history of dysplastic nevi. 3 AMH were removed 9.5 and 5 years ago. Margins taken were 3,4, and 5 mm. No pigment regrowth in 3 & 4 mm margn nevi, so I may finally stop freaking out about these and my concern that doctor should have takn 5 mm.

      Moving forward, I have had 2 or 3 severely atypical nevi. I just had one biopsied. My derm was certain via dermoscopy that it would come back mildly atypcial at worst. She was wrong – it is severe. My concern is 3% of severely atypical nevi that actually turn out to be melanoma on reexcision. My hope is that if dermascopically it only looked atypical, that it is truly a nevus and not a melanoma. 

      I am spinning because I am concerned about the nevi removed with 3 and 4 mm margins 9+ years ago. If these were going to recur, would they have already done so? 

      I really had myself convinced that my days of big excisions were behind me. I have so few moles left at this point, and get a full body check every 4 months, and go in if anything else concerns me. I did, in fact, have another derm look at this mole a few week ago.

      i have  a 3 year old that has had a congenital nevus on his scalp biopsied. It came back "congenital nevus with random cytologic atypia mostl likely due to anatomical site". Path recommended removal if clinical atypical. 3 derms say it is fine, and to leave it. I have an appointment tomorrow with his pediatric derm to discuss reomoval now.

      Any advise out there regarding my concerns for my 9 year old smaller than desired excisions, my current severely atypical nevus, or my son's nevus?

      Finally, i have read frequently that a pathologist will call something severe or AMH rather than melanoma to support a patient in terms of insurance. This doesn't make sense to me as I would think it would open a doctor up to a future law suit if it turns out to be worse. Any thoughts? My OCD can use any help or guidance today.  Thank you.

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          There is no good pathologist that would knowingly call something benign when it is cancerous. Atypical, even serverly atypical, does not mean melanoma. A lesion can stay severly atypical without ever becoming cancerous. I would certainly not worry about an excision you had 9 years ago. Continue with regular derm visits and skin checks. Get the excisions for severly atypical stuff. Don't stress about your 3 year old getting melanoma, that would be extremely rare and sounds like he had the biopsy and it doesn't sound like it is anything worrisome at all. Basically, no need to worry when there isn't anything to worry about, you've done the right things thus far and I'd continue to do what you've been doing. If you really don't trust the pathologist looking at your slides, you can always have them sent elsewhere for a second opinion.


              Thank you very much for your reply. Yours is the approach I will take.

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