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Surgery for deep subQs?

Forums General Melanoma Community Surgery for deep subQs?

  • Post
    KatyWI
    Participant

    So my 3-month PET wasn't exactly what I wanted – there are three small (4-5 mm), low-SUV (1-2) nodules in various places in my butt.  Could be nothing (e.g., cysts), but with MM…nothing's ever "nothing."  The nurse mentioned one possible outcome would be to have a surgeon remove them.  My doctor's appointment isn't until Thursday, but of course I want to go in armed with as much info as possible.  So here's the question:  two of the nodules are too deep to feel (one is 1 cm beneath the skin, and another is deeper still)

    So my 3-month PET wasn't exactly what I wanted – there are three small (4-5 mm), low-SUV (1-2) nodules in various places in my butt.  Could be nothing (e.g., cysts), but with MM…nothing's ever "nothing."  The nurse mentioned one possible outcome would be to have a surgeon remove them.  My doctor's appointment isn't until Thursday, but of course I want to go in armed with as much info as possible.  So here's the question:  two of the nodules are too deep to feel (one is 1 cm beneath the skin, and another is deeper still).  I can't feel these two.  How would a surgeon even find them to take out?  And what exactly would the surgeon take out?  My two previous subQs have been near the skin surface on my back and they were removed in a procedure analagous to a WLE, including an ellipse of surface skin.  That doesn't make sense to me for the deeper ones.

    Anybody have experience?  How is surgery handled for deep, small lesions?

    KatyWI, Stage IV, maybe still NED 4 months, or maybe not.

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      Eileen L
      Participant

      Katy, I had a sub q in my buttock that no one could feel. Went to see the surgeon. Not only did he immediately feel it (magic fingers!) but was able to see it with a portable ultrasound. He could tell that although the tumor was deep into the sub-q tissue it looked as though it was just above the muscle so he went in surgically and popped it out. It was done under "conscious sedation" and the recovery involved minimal pain and discomfort. So go ahead and get a surgical consult. The surgeon is the best person to evaluate if the tumors are easily removed or if it might involve going into muscle, which would pose a whole other set of potential issues surgically and post-operatively.

      Eileen L

      Stage IV

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        KatyWI
        Participant

        Thank you Eileen!  A little bit of encouragement goes a long way.  I like my muscles quite a lot the way they are and really that's mey cheif worry.  I haven't seen the PET films or even the report yet myself so maybe mine are all above the muscle.

        KatyWI

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        KatyWI
        Participant

        Thank you Eileen!  A little bit of encouragement goes a long way.  I like my muscles quite a lot the way they are and really that's mey cheif worry.  I haven't seen the PET films or even the report yet myself so maybe mine are all above the muscle.

        KatyWI

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      Eileen L
      Participant

      Katy, I had a sub q in my buttock that no one could feel. Went to see the surgeon. Not only did he immediately feel it (magic fingers!) but was able to see it with a portable ultrasound. He could tell that although the tumor was deep into the sub-q tissue it looked as though it was just above the muscle so he went in surgically and popped it out. It was done under "conscious sedation" and the recovery involved minimal pain and discomfort. So go ahead and get a surgical consult. The surgeon is the best person to evaluate if the tumors are easily removed or if it might involve going into muscle, which would pose a whole other set of potential issues surgically and post-operatively.

      Eileen L

      Stage IV

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      King
      Participant

      Katy,

       

      I had a 6mm deep subq in my upper butt that showed up on a PET/CT as well.  It could not be felt by me, my medical oncologist nor a pathologist.  A few days later, I had a US (ultrasound) guided biopsy…it was located easily and the biopsy was obtained (positive for melanoma).

       

      I also had a recurrence around my pancreas at the same time.  The subq was removed during the same surgery that was done for the peri-pancreatic tumor.  So, since I was sound asleep (general anesthetic), I'm not sure how it was located this time…I do know I have a 7 inch scar from it.  But it's gone.

       

      Stay Strong
      King

      Stage IV 7/05 Liver mets

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      King
      Participant

      Katy,

       

      I had a 6mm deep subq in my upper butt that showed up on a PET/CT as well.  It could not be felt by me, my medical oncologist nor a pathologist.  A few days later, I had a US (ultrasound) guided biopsy…it was located easily and the biopsy was obtained (positive for melanoma).

       

      I also had a recurrence around my pancreas at the same time.  The subq was removed during the same surgery that was done for the peri-pancreatic tumor.  So, since I was sound asleep (general anesthetic), I'm not sure how it was located this time…I do know I have a 7 inch scar from it.  But it's gone.

       

      Stay Strong
      King

      Stage IV 7/05 Liver mets

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