› Forums › General Melanoma Community › Sore on my neck
- This topic has 14 replies, 6 voices, and was last updated 13 years, 1 month ago by
Bombeni.
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- January 28, 2011 at 7:30 pm
Hi everyone. I had a sore develop on my neck around Thanksgiving. I have never had any moles, and for a couple of weeks I figured it was a bug bite. It is about half the size of eraser, blackish but when I wash sometimes the surface sloughs off and it is red and bleeding. Oh, early last Fall I lost 25 pounds in a matter of a couple of weeks, having weighed the same thing for 20 years.
Hi everyone. I had a sore develop on my neck around Thanksgiving. I have never had any moles, and for a couple of weeks I figured it was a bug bite. It is about half the size of eraser, blackish but when I wash sometimes the surface sloughs off and it is red and bleeding. Oh, early last Fall I lost 25 pounds in a matter of a couple of weeks, having weighed the same thing for 20 years.
I am a computer dodo. I have a camera phone and took a picture of this thing. I wish I knew how to send the picture for others to look at. I did see a derm. and he is going to excise a very large area on Feb. 7, I fully expected for him to do a simple biopsy the day I was in his office TWO WEEKS AGO, ERRRR. But he only works part time now and first appt was Feb. 7 to excise this. He drew the size and shape of a human eye which he is planning to take out. Now, doesn't that seem like a somewhat radical thing, taking that much area and of course will have a scar (he said 6 stitches) before he knows for sure if it is cancer? I know he is one of the most respected derms in Tulsa, but does anyone feel I should go somewhere else to have a simple punch or shave (I've been studying) biopsy first? Thank you for any replies.
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- January 28, 2011 at 7:47 pm
If it is MM, an excisional biopsy is definitely best. Usually we have to fight to get them; derms often prefer to shave because it's easy. Yes, you're going to have a scar, but you can make better informed decisions with a excisional biopsy because you get an accurate depth. And if it's not MM, so much the better – it'll be gone. Hoping for this outcome for you!
KatyWI
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- January 28, 2011 at 7:47 pm
If it is MM, an excisional biopsy is definitely best. Usually we have to fight to get them; derms often prefer to shave because it's easy. Yes, you're going to have a scar, but you can make better informed decisions with a excisional biopsy because you get an accurate depth. And if it's not MM, so much the better – it'll be gone. Hoping for this outcome for you!
KatyWI
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- January 28, 2011 at 8:09 pm
Hi, it's fantastic that your derm is doing an excisional biopsy, and what you have described – the eye shape – is also really good. It is called an elliptical cut and is generally what a plastic surgeon would choose in a visible area. This cut takes out all the lesion, plus small margins all around and underneath, but most importantly, it allows the surgeon to make a straight line when they put the stitches in. This will give you a much better scar over time, almost invisible. A straight line of the size you are talking about (six stitches) will heal flat. It is a good thing! Best of luck with your result.
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- January 28, 2011 at 8:09 pm
Hi, it's fantastic that your derm is doing an excisional biopsy, and what you have described – the eye shape – is also really good. It is called an elliptical cut and is generally what a plastic surgeon would choose in a visible area. This cut takes out all the lesion, plus small margins all around and underneath, but most importantly, it allows the surgeon to make a straight line when they put the stitches in. This will give you a much better scar over time, almost invisible. A straight line of the size you are talking about (six stitches) will heal flat. It is a good thing! Best of luck with your result.
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- January 29, 2011 at 1:15 pm
I you want to, you can upload a photo to a site like http://imgur.com/ and then post the generated link here. However, nobody here will be able to give you a diagnose just from looking at a picture…
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- January 29, 2011 at 1:15 pm
I you want to, you can upload a photo to a site like http://imgur.com/ and then post the generated link here. However, nobody here will be able to give you a diagnose just from looking at a picture…
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- January 29, 2011 at 3:49 pm
I believe your doctor’s plan does not follow the latest standard of care.
1) the biopsy must only remove the lesion (critical for later procedures needed if malignancy is found in order to determine stage of cancer)
2) If the biopsy comes back positive for melanoma, more tissue will need to be excised (larger margins for deeper lesions) but only after SNB is complete
3) SNB (Sentinel Node Biopsy) is needed if lesion is deeper than 1 mm (as indicated on initial biopsy results)If your doctor is allowed to do the excision as you describe and the biopsy comes back positive for melanoma more than 1 mm deep, the SNB that is needed next won’t be accurate, and this could throw off your staging…possibly leading to a mis-diagnosis…which could put your life in jeopardy.
I strongly recommend getting a second opinion. Find another doctor who can see you immediately and stress to the person making the appointment that you will need an excisional biopsy performed in THIS visit.
Best regards,
Mark (Stage 2A) from California-
- January 29, 2011 at 4:26 pm
Excisional biospies do not negate the accuracy of a SNB. A LARGE excisional biopsy has the possibility of compromising an SNB, but an excisional biopsy is NOT against the standard of care. Some doctors use them regularly on lesions suspicious for cancer (not just melanoma). Many melanoma patients won't have anything different on new biopsies. All biopsy types have their pros and cons. Most doctors don't use them because they require more time, remove more material and leave bigger scars. The goal of removing the entire lesion with the biopsy but not much more can be done with an excisional biopsy. If for some reason, a lymph paths were compromised and staging couldn't be comfirmed with a SNB – I don't see how this would lead to a misdiagnosis of any type. It is also possible that the doctor suspects another type of lesion altogether. Biopsy types are best discussed with the doctor because there are times and places for each biopsy technique based on anatomy or other considerations.
Best wishes,
Janner
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- February 24, 2011 at 3:49 pm
I finally saw another dermatologist yesterday and I liked him very much. He did a shave biopsy on my neck but it seems like he did a very deep one, as far as I can tell. He sent me across the street to a diagnotic lab to have bloodwork done which I wasn't expecting; they took 4 vials, and he also ordered chest x-rays. I thought that was odd but didn't say anything. I just didn't expect a dermatologist to send me to blood lab and radiology before results of biopsy even back. Of course, I'm thinking this means something, like he thinks something will be found. Ah well, I'm just glad to finally be getting to the bottom of this situation.
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- February 24, 2011 at 3:49 pm
I finally saw another dermatologist yesterday and I liked him very much. He did a shave biopsy on my neck but it seems like he did a very deep one, as far as I can tell. He sent me across the street to a diagnotic lab to have bloodwork done which I wasn't expecting; they took 4 vials, and he also ordered chest x-rays. I thought that was odd but didn't say anything. I just didn't expect a dermatologist to send me to blood lab and radiology before results of biopsy even back. Of course, I'm thinking this means something, like he thinks something will be found. Ah well, I'm just glad to finally be getting to the bottom of this situation.
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- February 24, 2011 at 3:49 pm
I finally saw another dermatologist yesterday and I liked him very much. He did a shave biopsy on my neck but it seems like he did a very deep one, as far as I can tell. He sent me across the street to a diagnotic lab to have bloodwork done which I wasn't expecting; they took 4 vials, and he also ordered chest x-rays. I thought that was odd but didn't say anything. I just didn't expect a dermatologist to send me to blood lab and radiology before results of biopsy even back. Of course, I'm thinking this means something, like he thinks something will be found. Ah well, I'm just glad to finally be getting to the bottom of this situation.
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- February 24, 2011 at 3:49 pm
I finally saw another dermatologist yesterday and I liked him very much. He did a shave biopsy on my neck but it seems like he did a very deep one, as far as I can tell. He sent me across the street to a diagnotic lab to have bloodwork done which I wasn't expecting; they took 4 vials, and he also ordered chest x-rays. I thought that was odd but didn't say anything. I just didn't expect a dermatologist to send me to blood lab and radiology before results of biopsy even back. Of course, I'm thinking this means something, like he thinks something will be found. Ah well, I'm just glad to finally be getting to the bottom of this situation.
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- January 29, 2011 at 4:26 pm
Excisional biospies do not negate the accuracy of a SNB. A LARGE excisional biopsy has the possibility of compromising an SNB, but an excisional biopsy is NOT against the standard of care. Some doctors use them regularly on lesions suspicious for cancer (not just melanoma). Many melanoma patients won't have anything different on new biopsies. All biopsy types have their pros and cons. Most doctors don't use them because they require more time, remove more material and leave bigger scars. The goal of removing the entire lesion with the biopsy but not much more can be done with an excisional biopsy. If for some reason, a lymph paths were compromised and staging couldn't be comfirmed with a SNB – I don't see how this would lead to a misdiagnosis of any type. It is also possible that the doctor suspects another type of lesion altogether. Biopsy types are best discussed with the doctor because there are times and places for each biopsy technique based on anatomy or other considerations.
Best wishes,
Janner
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- January 29, 2011 at 3:49 pm
I believe your doctor’s plan does not follow the latest standard of care.
1) the biopsy must only remove the lesion (critical for later procedures needed if malignancy is found in order to determine stage of cancer)
2) If the biopsy comes back positive for melanoma, more tissue will need to be excised (larger margins for deeper lesions) but only after SNB is complete
3) SNB (Sentinel Node Biopsy) is needed if lesion is deeper than 1 mm (as indicated on initial biopsy results)If your doctor is allowed to do the excision as you describe and the biopsy comes back positive for melanoma more than 1 mm deep, the SNB that is needed next won’t be accurate, and this could throw off your staging…possibly leading to a mis-diagnosis…which could put your life in jeopardy.
I strongly recommend getting a second opinion. Find another doctor who can see you immediately and stress to the person making the appointment that you will need an excisional biopsy performed in THIS visit.
Best regards,
Mark (Stage 2A) from California
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Tagged: cutaneous melanoma
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