Still early on in this process. Had WLE (primary tumor was 6mm+, so there's a big old scar down my thigh) and SLNB on Tuesday. Pathology on the SLNB came back today.
Apparently, I drained to only one sentinel node, so they only took one. The good news is that there is clearly no MACROmetasteses. However, they seem to be unsure if there's MICROmetasteses
Pathology says:
Left inguinal sentinel lymph node:
— Two SOX10+ cells of uncertain significance (see comment)
Comment: There are two cells in the subcapsular sinus of block A4 that
demonstrate nuclear SOX10 positive signal. They are concerning for
micrometastatic melanoma, identifiable by immunostain only. However no
corresponding cells are identified on the Melan-A immunostain or the
hematoxylin eosin sections and it is difficult to be sure of the meaning of these two cells.
Later it says:
Size of largest metastatic focus: Two cells measure less than 0.01 mm in diameter.
Based on my (probably incompetent) poking around in the medical literature, it sounds like SOX10 is a better "identifier" of micrometastatic "action" than Melan-A or hematoxylin eosin, so that would make me think that maybe there is micrometasteses, BUT there's only two tiny cells that show that give off the SOX10 signal, so maybe not?
If I understand staging correctly, I'm either Stage IIC (T4bN0M0), or I'm Stage IIIB (T4bN1aM0).
They're planning PET scan and brain MRI next, but if those come back clean, am I right that my optimal treatment plan would be significantly different if I'm Stage 3B rather than 2C?
I'm curious if any of the good folks on here (and you guys are amazing BTW) have faced this "has it metastasized or not" question before. Overall, I'm obviously thrilled that there's no obvious micrometasteses, but I'm wondering if those who keep on the medicine and treatment plans would suggest treating it more like a 2c or more like a 3b if we don't learn anything more? (Or maybe it doesn't make that much difference and my assumption that the treatment plans would be way different is incorrect?)
If anyone has thoughts/suggestions, I'd love to hear them. Thanks again for all the good work so many of you do in giving guidance and advice!!
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