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Treatment for a Spitz Nevus in child, age 6

Forums General Melanoma Community Treatment for a Spitz Nevus in child, age 6

  • Post
    boomer4676
    Participant

      Hello, I am trying to find out information about spitz nevi in children. 
      In April, my then 5 year old son had what looked like a sticker on his shoulder. Because we live out in the country and he is 100% boy, it wasn't out of the norm for him. We put drawing salve and a bandaid on it and waited for the sticker to come out, only it didn't. 
      Over a few short days, the sticker began to look like a wart. We treated it with Compound W. Needless to say, he is way too much boy for a small patch to stay on for the amount of time required. We spoke to our pharamsist, they reccommended freeze away. The "wart" began shrinking only to spring up again. 

       

      We took him to our local doctor to have it removed. He told us it was not a wart and cut out 1mm on all sides and 1/2 cm down to remove the "wart" and sent it to pathology. After waiting almost an entire month and three pathology reports, we were told it was melanoma. Finally we were sent to Denver Children's. 

       

      We had to wait almost 3 weeks for Children's get obtain the slides. They were hoping to find the lesion itself but did NOT ever find it…how nice. Our local doctor's office was SLOW getting anything sent to Denver even though they promised my son's information would be there for the appointment. Once the doctor obtained the slides and reviewed them, we were told it was a spitz nevus. 

      The Denver doctors would like to cut it open again. I am simply confused as to of WHY. His surgery is set for Friday and should last an hour and a half. I am not feeling very comfortable with the opperation. Has anyone else dealt with this? 
      I have read some posts about spitz nevi in children but no one has ever had them removed and then removed again! How will they know where to even opperate?!?! 

       

      Thank you! 

      Seriously frusterated mommy. 

    Viewing 16 reply threads
    • Replies
        Janner
        Participant

          Spitz nevi are totally benign and often found in young kids.  Melanoma is very rare in young kids but does happen. The problem is, both look almost identical under the microscope.  So I can see that the Denver docs might be erring on the side of caution – remove enough tissue "just in case" the melanoma diagnosis is correct even while knowing the Spitz Nevus is the most likely diagnosis. 

          Now as to not knowing where to operate, have you tried looking at your son's skin with the magnifying glass?  Is there no indication of the previous scar with very close scrutiny.  I certainly would want to know the surgery was taking place at the correct location and unless that could be readily identified, I'd ask more questions.

          I will also recommend Dr. Boris Bastian.  I believe he is at UCSF, but he's done a lot of research into the differences between Spitz and melanoma.  I might consider having my slides sent to him for another opinion – especially if the surgical site is so hard to identify.  If his diagnosis is Spitz and the biopsy site can't be identified, I might just skip that step. 

          Sorry you are having to deal with this.

          Janner
          Participant

            Spitz nevi are totally benign and often found in young kids.  Melanoma is very rare in young kids but does happen. The problem is, both look almost identical under the microscope.  So I can see that the Denver docs might be erring on the side of caution – remove enough tissue "just in case" the melanoma diagnosis is correct even while knowing the Spitz Nevus is the most likely diagnosis. 

            Now as to not knowing where to operate, have you tried looking at your son's skin with the magnifying glass?  Is there no indication of the previous scar with very close scrutiny.  I certainly would want to know the surgery was taking place at the correct location and unless that could be readily identified, I'd ask more questions.

            I will also recommend Dr. Boris Bastian.  I believe he is at UCSF, but he's done a lot of research into the differences between Spitz and melanoma.  I might consider having my slides sent to him for another opinion – especially if the surgical site is so hard to identify.  If his diagnosis is Spitz and the biopsy site can't be identified, I might just skip that step. 

            Sorry you are having to deal with this.

            Janner
            Participant

              Spitz nevi are totally benign and often found in young kids.  Melanoma is very rare in young kids but does happen. The problem is, both look almost identical under the microscope.  So I can see that the Denver docs might be erring on the side of caution – remove enough tissue "just in case" the melanoma diagnosis is correct even while knowing the Spitz Nevus is the most likely diagnosis. 

              Now as to not knowing where to operate, have you tried looking at your son's skin with the magnifying glass?  Is there no indication of the previous scar with very close scrutiny.  I certainly would want to know the surgery was taking place at the correct location and unless that could be readily identified, I'd ask more questions.

              I will also recommend Dr. Boris Bastian.  I believe he is at UCSF, but he's done a lot of research into the differences between Spitz and melanoma.  I might consider having my slides sent to him for another opinion – especially if the surgical site is so hard to identify.  If his diagnosis is Spitz and the biopsy site can't be identified, I might just skip that step. 

              Sorry you are having to deal with this.

              boomer4676
              Participant

                Thank you!!! Granted, I have learned that spitz and melamona look so much a like under the scope. I don't know how to say this, the local doctors told us it WAS melanoma and said it was on the path reports….the Denver docs read the same reports and melanoma was NOT on them.  ๐Ÿ™ That is why I am just so confused and upset at our local clinic. 

                 

                You can see where it was, but they don't have a clue how much is 5 mm or anything outside of the lesion. You can't just look at the scar and know where it was removed from. 

                I have seen so many people refer to Dr Bastian. How do I get in contact with him?? It almost seems like the best idea really. 

                 

                Thanks again. 

                Janner
                Participant

                  I do not have contact information.  You will just have to do a search and see what comes up. 

                  As for the scar area, in general they'd just take from the center of the scar area on out.  But that would best be discussed with the surgeon.  

                  Good luck!

                  malika
                  Participant

                    Hi

                    We have been in your shoes!  A mole (nevus) appeared on our then 7-year old's shin.  It is a long process to get to a diagnosis.  Our pathologist sent my son's slides to be analyzed with a Florescence in-situ hybridization (FISH)  testbecause it was so hard to distinguish between a spitz nevus and a melanoma.  We, too, found it hard to locate any experts.

                    Here are some statistics to help put the chance of melanoma in a kid in perspective.  According to St Jude's Children's Research Hospital, there are fewer than 70 cases of melanoma in kids under 10 in the US annually, and fewer than ten kids diagnosed with an advanced stage of the disease. (My black-Filipino son was one of those kids, putting his likelihood very low – there is about 1 non-white child under 10 years old in the US diagnosed each year).

                    The St Jude Promise Magazine has an article on pediatric melanoma in its summer issue, and is available here http://www.stjude.org/stjude/v/index.jsp?vgnextoid=a411b0cf6626f310VgnVCM100000290115acRCRD

                    My advice is to keep pushing for more information and keep asking questions until you are satisfied with an answer.  And, keep bring your son to the dermatologist even after all this is behind you.  I figure my son Asa will be going to the derm every three months for years to come!!

                    Best of luck

                    "Malika"

                    malika
                    Participant

                      Hi

                      We have been in your shoes!  A mole (nevus) appeared on our then 7-year old's shin.  It is a long process to get to a diagnosis.  Our pathologist sent my son's slides to be analyzed with a Florescence in-situ hybridization (FISH)  testbecause it was so hard to distinguish between a spitz nevus and a melanoma.  We, too, found it hard to locate any experts.

                      Here are some statistics to help put the chance of melanoma in a kid in perspective.  According to St Jude's Children's Research Hospital, there are fewer than 70 cases of melanoma in kids under 10 in the US annually, and fewer than ten kids diagnosed with an advanced stage of the disease. (My black-Filipino son was one of those kids, putting his likelihood very low – there is about 1 non-white child under 10 years old in the US diagnosed each year).

                      The St Jude Promise Magazine has an article on pediatric melanoma in its summer issue, and is available here http://www.stjude.org/stjude/v/index.jsp?vgnextoid=a411b0cf6626f310VgnVCM100000290115acRCRD

                      My advice is to keep pushing for more information and keep asking questions until you are satisfied with an answer.  And, keep bring your son to the dermatologist even after all this is behind you.  I figure my son Asa will be going to the derm every three months for years to come!!

                      Best of luck

                      "Malika"

                      malika
                      Participant

                        Hi

                        We have been in your shoes!  A mole (nevus) appeared on our then 7-year old's shin.  It is a long process to get to a diagnosis.  Our pathologist sent my son's slides to be analyzed with a Florescence in-situ hybridization (FISH)  testbecause it was so hard to distinguish between a spitz nevus and a melanoma.  We, too, found it hard to locate any experts.

                        Here are some statistics to help put the chance of melanoma in a kid in perspective.  According to St Jude's Children's Research Hospital, there are fewer than 70 cases of melanoma in kids under 10 in the US annually, and fewer than ten kids diagnosed with an advanced stage of the disease. (My black-Filipino son was one of those kids, putting his likelihood very low – there is about 1 non-white child under 10 years old in the US diagnosed each year).

                        The St Jude Promise Magazine has an article on pediatric melanoma in its summer issue, and is available here http://www.stjude.org/stjude/v/index.jsp?vgnextoid=a411b0cf6626f310VgnVCM100000290115acRCRD

                        My advice is to keep pushing for more information and keep asking questions until you are satisfied with an answer.  And, keep bring your son to the dermatologist even after all this is behind you.  I figure my son Asa will be going to the derm every three months for years to come!!

                        Best of luck

                        "Malika"

                        Ali
                        Participant

                          UCSF can do DNA testing on a questionable spitz diagnosis (your dr. can order that and send it out).  That is what they did with mine.  It took a long time to get back (3 months?  I wonder if they do it faster now, that was 6 years ago).  I wish I would have treated it like a melanoma from the beginning (it was taken off in a shave biopsy, they did not get the real depth "at least 2.5 mm") while waiting to get the results.  I would have done the deeper excision and the sentinel node biopsy (they do this depending on how deep the original lesion went, determined under the microscope). 

                          Hopefully that is not what you are dealing with, but I would want to know for sure.

                          Good luck!

                          Ali

                          Ali
                          Participant

                            UCSF can do DNA testing on a questionable spitz diagnosis (your dr. can order that and send it out).  That is what they did with mine.  It took a long time to get back (3 months?  I wonder if they do it faster now, that was 6 years ago).  I wish I would have treated it like a melanoma from the beginning (it was taken off in a shave biopsy, they did not get the real depth "at least 2.5 mm") while waiting to get the results.  I would have done the deeper excision and the sentinel node biopsy (they do this depending on how deep the original lesion went, determined under the microscope). 

                            Hopefully that is not what you are dealing with, but I would want to know for sure.

                            Good luck!

                            Ali

                            Ali
                            Participant

                              UCSF can do DNA testing on a questionable spitz diagnosis (your dr. can order that and send it out).  That is what they did with mine.  It took a long time to get back (3 months?  I wonder if they do it faster now, that was 6 years ago).  I wish I would have treated it like a melanoma from the beginning (it was taken off in a shave biopsy, they did not get the real depth "at least 2.5 mm") while waiting to get the results.  I would have done the deeper excision and the sentinel node biopsy (they do this depending on how deep the original lesion went, determined under the microscope). 

                              Hopefully that is not what you are dealing with, but I would want to know for sure.

                              Good luck!

                              Ali

                              achampagne
                              Participant

                                Hello,

                                I am confused as to why it took so long for results. I brought my 3 year old daughter to her dermatologist on Aug 19. The Dr cut out the "growth" and told us he was going to send it to biopsy. He called me just a few minutes ago today, Aug 26, one week later with results. He said it was Spitz Nevus and that they would like her to go back to the office so they can remove more tissue down to the fatty cells to make sure that it is all removed. They will do it in the office. First numb the area, then scrape what needs to be cut out, then stitch it up. We will follow up in 10 days to remove the stitches and then once a year to check on the area to make sure it doesn't return. So we do have the same course of treatment as you, just much much quicker. Hope all turns out well.

                                achampagne
                                Participant

                                  Hello,

                                  I am confused as to why it took so long for results. I brought my 3 year old daughter to her dermatologist on Aug 19. The Dr cut out the "growth" and told us he was going to send it to biopsy. He called me just a few minutes ago today, Aug 26, one week later with results. He said it was Spitz Nevus and that they would like her to go back to the office so they can remove more tissue down to the fatty cells to make sure that it is all removed. They will do it in the office. First numb the area, then scrape what needs to be cut out, then stitch it up. We will follow up in 10 days to remove the stitches and then once a year to check on the area to make sure it doesn't return. So we do have the same course of treatment as you, just much much quicker. Hope all turns out well.

                                  achampagne
                                  Participant

                                    Hello,

                                    I am confused as to why it took so long for results. I brought my 3 year old daughter to her dermatologist on Aug 19. The Dr cut out the "growth" and told us he was going to send it to biopsy. He called me just a few minutes ago today, Aug 26, one week later with results. He said it was Spitz Nevus and that they would like her to go back to the office so they can remove more tissue down to the fatty cells to make sure that it is all removed. They will do it in the office. First numb the area, then scrape what needs to be cut out, then stitch it up. We will follow up in 10 days to remove the stitches and then once a year to check on the area to make sure it doesn't return. So we do have the same course of treatment as you, just much much quicker. Hope all turns out well.

                                    achampagne
                                    Participant

                                      Hello,

                                      I am confused as to why it took so long for results. I brought my 3 year old daughter to her dermatologist on Aug 19. The Dr cut out the "growth" and told us he was going to send it to biopsy. He called me just a few minutes ago today, Aug 26, one week later with results. He said it was Spitz Nevus and that they would like her to go back to the office so they can remove more tissue down to the fatty cells to make sure that it is all removed. They will do it in the office. First numb the area, then scrape what needs to be cut out, then stitch it up. We will follow up in 10 days to remove the stitches and then once a year to check on the area to make sure it doesn't return. So we do have the same course of treatment as you, just much much quicker. Hope all turns out well.

                                      achampagne
                                      Participant

                                        Hello,

                                        I am confused as to why it took so long for results. I brought my 3 year old daughter to her dermatologist on Aug 19. The Dr cut out the "growth" and told us he was going to send it to biopsy. He called me just a few minutes ago today, Aug 26, one week later with results. He said it was Spitz Nevus and that they would like her to go back to the office so they can remove more tissue down to the fatty cells to make sure that it is all removed. They will do it in the office. First numb the area, then scrape what needs to be cut out, then stitch it up. We will follow up in 10 days to remove the stitches and then once a year to check on the area to make sure it doesn't return. So we do have the same course of treatment as you, just much much quicker. Hope all turns out well.

                                        achampagne
                                        Participant

                                          Hello,

                                          I am confused as to why it took so long for results. I brought my 3 year old daughter to her dermatologist on Aug 19. The Dr cut out the "growth" and told us he was going to send it to biopsy. He called me just a few minutes ago today, Aug 26, one week later with results. He said it was Spitz Nevus and that they would like her to go back to the office so they can remove more tissue down to the fatty cells to make sure that it is all removed. They will do it in the office. First numb the area, then scrape what needs to be cut out, then stitch it up. We will follow up in 10 days to remove the stitches and then once a year to check on the area to make sure it doesn't return. So we do have the same course of treatment as you, just much much quicker. Hope all turns out well.

                                          boomer4676
                                          Participant

                                            Thank you!!! Granted, I have learned that spitz and melamona look so much a like under the scope. I don't know how to say this, the local doctors told us it WAS melanoma and said it was on the path reports….the Denver docs read the same reports and melanoma was NOT on them.  ๐Ÿ™ That is why I am just so confused and upset at our local clinic. 

                                             

                                            You can see where it was, but they don't have a clue how much is 5 mm or anything outside of the lesion. You can't just look at the scar and know where it was removed from. 

                                            I have seen so many people refer to Dr Bastian. How do I get in contact with him?? It almost seems like the best idea really. 

                                             

                                            Thanks again. 

                                            boomer4676
                                            Participant

                                              Thank you!!! Granted, I have learned that spitz and melamona look so much a like under the scope. I don't know how to say this, the local doctors told us it WAS melanoma and said it was on the path reports….the Denver docs read the same reports and melanoma was NOT on them.  ๐Ÿ™ That is why I am just so confused and upset at our local clinic. 

                                               

                                              You can see where it was, but they don't have a clue how much is 5 mm or anything outside of the lesion. You can't just look at the scar and know where it was removed from. 

                                              I have seen so many people refer to Dr Bastian. How do I get in contact with him?? It almost seems like the best idea really. 

                                               

                                              Thanks again. 

                                              Janner
                                              Participant

                                                I do not have contact information.  You will just have to do a search and see what comes up. 

                                                As for the scar area, in general they'd just take from the center of the scar area on out.  But that would best be discussed with the surgeon.  

                                                Good luck!

                                                Janner
                                                Participant

                                                  I do not have contact information.  You will just have to do a search and see what comes up. 

                                                  As for the scar area, in general they'd just take from the center of the scar area on out.  But that would best be discussed with the surgeon.  

                                                  Good luck!

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