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I am a 41 year old female. I had a mole that newly presented on the back of my knee. It was about 6mm and very very black. I had it biopsied and the results were: Spitz Nevus – Junctional. The report read orderly nests were present, large nuclei, and some pagetoid spread with many melanocytes present. It was recommended that I have a complete re-excision to remove it completely due to my age, rareness of this growth, and because atypical cells were present. I had the re-excision and I am awaiting the results. I am concerned because I have read about misdiagnosis being common in adult patients with spitz nevus. I have a family history of melanoma with an uncle diagnosed with Ocular Melanoma and a maternal first cousin diagnosed at the age of 24. Both family members were diagnosed stage IV. Should I have a second opinion? or is this pretty standard?
Hi, Anon: I’m fairly new to the forum and haven’t yet posted my story, but your post sounds a lot like what I experienced with my melanoma diagnosis. Have you had genetic testing done on the biopsy and/or on yourself to check for somatic mutations? There is a mutation called BAP1 that causes what are often called Spitz Nevis but they are moles that contain BAP1 loss and are actually considered by many as bapomas. These are often difficult to diagnose with pathology and contain melanocytic cells and do in fact often evolve into melanoma – at least that was my exzperience. BAP1 is considered a cancer syndrome gene mutation and causes a number of cancers, including uveal melanoma. Given your family history, I think you would be really smart to get a second opinion and ask for genetic testing. I had a challenging pathology report that sounds similar to yours and it turned out to be stage IIB melanoma. I also was found to have the BAP1 mutation and unfortunately have progressed to Stage IV. I’m in a clinical trial now since immunotherapy didn’t work for me (as it often doesn’t for melanoma with BAP1 mutation that often behaves like a uveal melanoma). Good luck and feel free to reach out I if I can help you with info…. I’m sorry you’re dealing with this and hope that you get good news and a speedy resolution.
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