› Forums › General Melanoma Community › Spitzoid in 35 year old man
- This topic has 24 replies, 3 voices, and was last updated 9 years, 8 months ago by
wifeofron.
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- June 1, 2016 at 3:37 pm
Our 35 year old son was diagnosed two months ago with a spitzoid Nevus moderate to severe. He recently had a wide local excision done and no sign of the prior biopsy was seen nor any remaining spitzoid even though margins were not clear on first biopsy. I am wondering if the appropriate area was even excised and I am also concerned because a DO pathologist and not a dermatologist did this second biopsy . My husband consequently was just diagnosed with melanoma one month ago and is scheduled for wide local excision Amy thoughts on this Janner ?
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- June 1, 2016 at 4:05 pm
Wifeofron, Not Janner but I am also 35 and had a spitz remove in February. I was called on the phone and told I had an atypical mole and that they needed to completly exsise it. When I arrived a month later the dermatolgoist said well your mole is a spitz nevus. It can be completly benign but we remove them in adults to be safe.
When I got home I started researching spitz nevus and became even more alarmed. I actually sought out and emailed my dermatopathologist ( I know… crazy but no one could answer my question). Here is exactly what he told me. Review the difference between the diagnosis and then the differential diagnosis. If a dermatopathologist reviewed the slides and there was any resemblence to melanoma then the differential diagnosis would reflect Possible spitzoid melanoma. He also said in his office when that differential diagnosis is made they will have other dermatopathologists review the specimen and then send it out for DNA testing to be sure.
He told me a trained dermatopathologist who has seen spitz and dealt with them can differentiate between a harmless/low atypia spitz and a melanoma. He explained that in an adult NO spitz will ever be labled benign and even if the spitz looks benign due to liabilty purporses it must be labled atypical. Their protocol for all atypical spitz in adults is to treat them like melanoma and remove the appropriate margins. I now have a nice 6 inch scar on my lef from my removal.
I would make sure your slide gets viewed by a dermatopathologist. From what I undertand the higher up the atypical range a spitz nevus gets the harder it is to differentiate between a melanoma.
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- June 1, 2016 at 4:05 pm
Wifeofron, Not Janner but I am also 35 and had a spitz remove in February. I was called on the phone and told I had an atypical mole and that they needed to completly exsise it. When I arrived a month later the dermatolgoist said well your mole is a spitz nevus. It can be completly benign but we remove them in adults to be safe.
When I got home I started researching spitz nevus and became even more alarmed. I actually sought out and emailed my dermatopathologist ( I know… crazy but no one could answer my question). Here is exactly what he told me. Review the difference between the diagnosis and then the differential diagnosis. If a dermatopathologist reviewed the slides and there was any resemblence to melanoma then the differential diagnosis would reflect Possible spitzoid melanoma. He also said in his office when that differential diagnosis is made they will have other dermatopathologists review the specimen and then send it out for DNA testing to be sure.
He told me a trained dermatopathologist who has seen spitz and dealt with them can differentiate between a harmless/low atypia spitz and a melanoma. He explained that in an adult NO spitz will ever be labled benign and even if the spitz looks benign due to liabilty purporses it must be labled atypical. Their protocol for all atypical spitz in adults is to treat them like melanoma and remove the appropriate margins. I now have a nice 6 inch scar on my lef from my removal.
I would make sure your slide gets viewed by a dermatopathologist. From what I undertand the higher up the atypical range a spitz nevus gets the harder it is to differentiate between a melanoma.
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- June 1, 2016 at 4:05 pm
Wifeofron, Not Janner but I am also 35 and had a spitz remove in February. I was called on the phone and told I had an atypical mole and that they needed to completly exsise it. When I arrived a month later the dermatolgoist said well your mole is a spitz nevus. It can be completly benign but we remove them in adults to be safe.
When I got home I started researching spitz nevus and became even more alarmed. I actually sought out and emailed my dermatopathologist ( I know… crazy but no one could answer my question). Here is exactly what he told me. Review the difference between the diagnosis and then the differential diagnosis. If a dermatopathologist reviewed the slides and there was any resemblence to melanoma then the differential diagnosis would reflect Possible spitzoid melanoma. He also said in his office when that differential diagnosis is made they will have other dermatopathologists review the specimen and then send it out for DNA testing to be sure.
He told me a trained dermatopathologist who has seen spitz and dealt with them can differentiate between a harmless/low atypia spitz and a melanoma. He explained that in an adult NO spitz will ever be labled benign and even if the spitz looks benign due to liabilty purporses it must be labled atypical. Their protocol for all atypical spitz in adults is to treat them like melanoma and remove the appropriate margins. I now have a nice 6 inch scar on my lef from my removal.
I would make sure your slide gets viewed by a dermatopathologist. From what I undertand the higher up the atypical range a spitz nevus gets the harder it is to differentiate between a melanoma.
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- June 1, 2016 at 4:52 pm
It is NOT uncommon not to see residual melanoma or atypical cells in a WLE. The act of healing or scaring can destroy leftover cells. Also, WLE tissue is much larger and is not analyzed as closely as biopsy tissue is. I don't really feel comfortable commenting on the Spitz tumor – I just haven't researched it enough. But I wouldn't be concerned at all that no residual tumor was found in the WLE tissue. As for margins, they should be indicated in the report.
If the pathologist sees lots of melanoma, I wouldn't be concerned. I prefer dermatopathologists because that is their specialty but if a pathologist sees lots of melanoma, it is probably ok for the WLE.
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- June 1, 2016 at 4:52 pm
It is NOT uncommon not to see residual melanoma or atypical cells in a WLE. The act of healing or scaring can destroy leftover cells. Also, WLE tissue is much larger and is not analyzed as closely as biopsy tissue is. I don't really feel comfortable commenting on the Spitz tumor – I just haven't researched it enough. But I wouldn't be concerned at all that no residual tumor was found in the WLE tissue. As for margins, they should be indicated in the report.
If the pathologist sees lots of melanoma, I wouldn't be concerned. I prefer dermatopathologists because that is their specialty but if a pathologist sees lots of melanoma, it is probably ok for the WLE.
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- June 1, 2016 at 4:52 pm
It is NOT uncommon not to see residual melanoma or atypical cells in a WLE. The act of healing or scaring can destroy leftover cells. Also, WLE tissue is much larger and is not analyzed as closely as biopsy tissue is. I don't really feel comfortable commenting on the Spitz tumor – I just haven't researched it enough. But I wouldn't be concerned at all that no residual tumor was found in the WLE tissue. As for margins, they should be indicated in the report.
If the pathologist sees lots of melanoma, I wouldn't be concerned. I prefer dermatopathologists because that is their specialty but if a pathologist sees lots of melanoma, it is probably ok for the WLE.
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- June 2, 2016 at 12:30 am
I would think you would see some "fibrosis" or some type of scar tissue mentioned in the WLE report but it might depend on how big a biopsy area was removed. It's not unusual for a biopsy to heal so well you lose track of where it was. I'm the type that takes pictures so I know I can find these areas but if your husband wasn't sure where it was, that makes it tough. All I can suggest is to watch the area around where the WLE was done for any type of regrowth. At this point, that's really all you can do.
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- June 2, 2016 at 12:30 am
I would think you would see some "fibrosis" or some type of scar tissue mentioned in the WLE report but it might depend on how big a biopsy area was removed. It's not unusual for a biopsy to heal so well you lose track of where it was. I'm the type that takes pictures so I know I can find these areas but if your husband wasn't sure where it was, that makes it tough. All I can suggest is to watch the area around where the WLE was done for any type of regrowth. At this point, that's really all you can do.
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- June 2, 2016 at 12:30 am
I would think you would see some "fibrosis" or some type of scar tissue mentioned in the WLE report but it might depend on how big a biopsy area was removed. It's not unusual for a biopsy to heal so well you lose track of where it was. I'm the type that takes pictures so I know I can find these areas but if your husband wasn't sure where it was, that makes it tough. All I can suggest is to watch the area around where the WLE was done for any type of regrowth. At this point, that's really all you can do.
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