› Forums › General Melanoma Community › What to ask the Dermatologist ?
- This topic has 24 replies, 7 voices, and was last updated 7 years, 3 months ago by
Nemesis.
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- January 29, 2017 at 6:52 pm
Hello. My significant other just call from his dermatologist 1/27/17 that he has Melanoma. The only thing that my significant other heard was that it was a 3mm . The dermatologist referred him to a general plastic surgeon for a non-urgent appointment at the end of March 2017.
Since then I have been reading your blogs and have learned a lot. What questions do we need to ask the dermatologist and shouldn't we be seeing a surgical oncologist since we will end up with an Oncologist anyway ? Please help.
- Replies
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- January 29, 2017 at 7:16 pm
Hi,
yes…if it has been confirmed he has melanoma, he will need to see a surgical oncologist. If they haven't done so as of now, your sigo will need a wide area excision and at 3mm very likely a sentinel node biopsy. I would also strongly recommend a melanoma specialist rather than a general dermatologist. Good luck and best wishes to your sigo.
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- January 29, 2017 at 7:16 pm
Hi,
yes…if it has been confirmed he has melanoma, he will need to see a surgical oncologist. If they haven't done so as of now, your sigo will need a wide area excision and at 3mm very likely a sentinel node biopsy. I would also strongly recommend a melanoma specialist rather than a general dermatologist. Good luck and best wishes to your sigo.
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- January 29, 2017 at 7:16 pm
Hi,
yes…if it has been confirmed he has melanoma, he will need to see a surgical oncologist. If they haven't done so as of now, your sigo will need a wide area excision and at 3mm very likely a sentinel node biopsy. I would also strongly recommend a melanoma specialist rather than a general dermatologist. Good luck and best wishes to your sigo.
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- January 29, 2017 at 7:18 pm
Your right about needing to see a surgical oncologist specifically a melanoma specialist. I would push for an app't asap as melanoma can grow fast. The smaller it is the easier it is to get rid of. Not to scare you but from the time I noticed it on my skin until surgery was 2 months and it had already spread to a lymph node. Also, call and get the dermatologist office to email you a copy of the biopsy report so you have the specifics.
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- January 29, 2017 at 7:18 pm
Your right about needing to see a surgical oncologist specifically a melanoma specialist. I would push for an app't asap as melanoma can grow fast. The smaller it is the easier it is to get rid of. Not to scare you but from the time I noticed it on my skin until surgery was 2 months and it had already spread to a lymph node. Also, call and get the dermatologist office to email you a copy of the biopsy report so you have the specifics.
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- January 29, 2017 at 7:18 pm
Your right about needing to see a surgical oncologist specifically a melanoma specialist. I would push for an app't asap as melanoma can grow fast. The smaller it is the easier it is to get rid of. Not to scare you but from the time I noticed it on my skin until surgery was 2 months and it had already spread to a lymph node. Also, call and get the dermatologist office to email you a copy of the biopsy report so you have the specifics.
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- January 29, 2017 at 8:35 pm
Hmmm….I would be moving much, much faster than the end of March. And not to a plastic surgeon but a surgical oncologist as mentioned above. I would get the details of your pathology ASAP and post them here for some "expert" help. (from those that have been there…done that, and sometimes more than once).
The odds are that you are a Stage 1…but only speed will keep you there. Many of us start at Stage 1 like yourself but based upon the results of your next appointments could move up like I did…from Stage 1 to Stage 3 and then stopped there.
Find a specialist and don't wait.
Best wishes
Michel
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- January 29, 2017 at 8:35 pm
Hmmm….I would be moving much, much faster than the end of March. And not to a plastic surgeon but a surgical oncologist as mentioned above. I would get the details of your pathology ASAP and post them here for some "expert" help. (from those that have been there…done that, and sometimes more than once).
The odds are that you are a Stage 1…but only speed will keep you there. Many of us start at Stage 1 like yourself but based upon the results of your next appointments could move up like I did…from Stage 1 to Stage 3 and then stopped there.
Find a specialist and don't wait.
Best wishes
Michel
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- January 29, 2017 at 8:35 pm
Hmmm….I would be moving much, much faster than the end of March. And not to a plastic surgeon but a surgical oncologist as mentioned above. I would get the details of your pathology ASAP and post them here for some "expert" help. (from those that have been there…done that, and sometimes more than once).
The odds are that you are a Stage 1…but only speed will keep you there. Many of us start at Stage 1 like yourself but based upon the results of your next appointments could move up like I did…from Stage 1 to Stage 3 and then stopped there.
Find a specialist and don't wait.
Best wishes
Michel
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- January 29, 2017 at 9:11 pm
Hello,
If you're able to post the actual results of the pathology report, others here can give excellent analysis and advice. I am thinking that maybe the lesion was on his face? That's why the plastic surgeon? Other advice here is spot-on. He will need a local wide excision, and lymph node biopsy at the same time, if lesion was in-fact 3mm deep (as opposed to wide). The sooner this happens the better. Frankly the dermatologist has little to do with this for the time being. Surgery and oncology take it from here.
Gary
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- January 30, 2017 at 10:19 pm
Hello. I posted this under my original post "what to ask a dermatologist" but I think I may have done something wrong because I haven't received any comments. I hope it is ok to post to your comment because I really need to know what the pathology report means..
Specimen:
A: 1172535. Right temple
B: 1172536. Left ChinRelevant Clinical Data:
A: Recurrent Neurofibroma
B: Pigmented nevusMicroscopic Diagnosis:
A: Malignant Melanoma: histologically amelanotic
B: Melanocytic nevus – Intradermal typeDescription:
Specimen A is a shave biopsy that in the papillary dermis shows some fine fibrils with small spindled nuclei that have no nuclear atypia. However, in the reticular dermis, there is a well-circumscribed neoplasm consisting of nested atypical cells without melanin pigment. These cells are epithelioid appearing, basically round with round to oval nuclei. The mitotic rate is 0 to 1 mitoses per mm2. There are very few tumor infiltrating lymphocytes. There is no evident intravascular invasion by atypical cells. The overlying epidermis has no evident atypical melanocytes.
Specimen A demonstrates:
A histologically amelanotic malignant melanoma. The neoplasm extends to the base of these sections and the tumor thickness is at least 3.6 mm confirming immunostains, namely vimentin, MART1 and s100 were positive for these cells.
Specimen B is a shave biopsy of a papule that has a normal epidermis. In the characteristics as they proceed deeper.
There is no nuclear atypia.
There is no evidence of dysplasia or malignancy in specimen B.
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- January 30, 2017 at 10:19 pm
Hello. I posted this under my original post "what to ask a dermatologist" but I think I may have done something wrong because I haven't received any comments. I hope it is ok to post to your comment because I really need to know what the pathology report means..
Specimen:
A: 1172535. Right temple
B: 1172536. Left ChinRelevant Clinical Data:
A: Recurrent Neurofibroma
B: Pigmented nevusMicroscopic Diagnosis:
A: Malignant Melanoma: histologically amelanotic
B: Melanocytic nevus – Intradermal typeDescription:
Specimen A is a shave biopsy that in the papillary dermis shows some fine fibrils with small spindled nuclei that have no nuclear atypia. However, in the reticular dermis, there is a well-circumscribed neoplasm consisting of nested atypical cells without melanin pigment. These cells are epithelioid appearing, basically round with round to oval nuclei. The mitotic rate is 0 to 1 mitoses per mm2. There are very few tumor infiltrating lymphocytes. There is no evident intravascular invasion by atypical cells. The overlying epidermis has no evident atypical melanocytes.
Specimen A demonstrates:
A histologically amelanotic malignant melanoma. The neoplasm extends to the base of these sections and the tumor thickness is at least 3.6 mm confirming immunostains, namely vimentin, MART1 and s100 were positive for these cells.
Specimen B is a shave biopsy of a papule that has a normal epidermis. In the characteristics as they proceed deeper.
There is no nuclear atypia.
There is no evidence of dysplasia or malignancy in specimen B.
-
- January 30, 2017 at 10:19 pm
Hello. I posted this under my original post "what to ask a dermatologist" but I think I may have done something wrong because I haven't received any comments. I hope it is ok to post to your comment because I really need to know what the pathology report means..
Specimen:
A: 1172535. Right temple
B: 1172536. Left ChinRelevant Clinical Data:
A: Recurrent Neurofibroma
B: Pigmented nevusMicroscopic Diagnosis:
A: Malignant Melanoma: histologically amelanotic
B: Melanocytic nevus – Intradermal typeDescription:
Specimen A is a shave biopsy that in the papillary dermis shows some fine fibrils with small spindled nuclei that have no nuclear atypia. However, in the reticular dermis, there is a well-circumscribed neoplasm consisting of nested atypical cells without melanin pigment. These cells are epithelioid appearing, basically round with round to oval nuclei. The mitotic rate is 0 to 1 mitoses per mm2. There are very few tumor infiltrating lymphocytes. There is no evident intravascular invasion by atypical cells. The overlying epidermis has no evident atypical melanocytes.
Specimen A demonstrates:
A histologically amelanotic malignant melanoma. The neoplasm extends to the base of these sections and the tumor thickness is at least 3.6 mm confirming immunostains, namely vimentin, MART1 and s100 were positive for these cells.
Specimen B is a shave biopsy of a papule that has a normal epidermis. In the characteristics as they proceed deeper.
There is no nuclear atypia.
There is no evidence of dysplasia or malignancy in specimen B.
-
- January 29, 2017 at 9:11 pm
Hello,
If you're able to post the actual results of the pathology report, others here can give excellent analysis and advice. I am thinking that maybe the lesion was on his face? That's why the plastic surgeon? Other advice here is spot-on. He will need a local wide excision, and lymph node biopsy at the same time, if lesion was in-fact 3mm deep (as opposed to wide). The sooner this happens the better. Frankly the dermatologist has little to do with this for the time being. Surgery and oncology take it from here.
Gary
-
- January 29, 2017 at 9:11 pm
Hello,
If you're able to post the actual results of the pathology report, others here can give excellent analysis and advice. I am thinking that maybe the lesion was on his face? That's why the plastic surgeon? Other advice here is spot-on. He will need a local wide excision, and lymph node biopsy at the same time, if lesion was in-fact 3mm deep (as opposed to wide). The sooner this happens the better. Frankly the dermatologist has little to do with this for the time being. Surgery and oncology take it from here.
Gary
-
- January 29, 2017 at 11:51 pm
Are you sure it is 3mm instead of .3mm? The two make a world of difference in melanoma. Timing has been studied and shown not to have any difference in outcome except angst for the patient. But I'd first request a copy of my pathology report so I could know exactly what I'm dealing with. If this is .3mm, then there is no need for a sentinel node biopsy. If it is 3mm, then a sentinel node biopsy is needed and therefore, a different doctor. Finding this out now could help with any future delays later.
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- January 29, 2017 at 11:51 pm
Are you sure it is 3mm instead of .3mm? The two make a world of difference in melanoma. Timing has been studied and shown not to have any difference in outcome except angst for the patient. But I'd first request a copy of my pathology report so I could know exactly what I'm dealing with. If this is .3mm, then there is no need for a sentinel node biopsy. If it is 3mm, then a sentinel node biopsy is needed and therefore, a different doctor. Finding this out now could help with any future delays later.
-
- January 29, 2017 at 11:51 pm
Are you sure it is 3mm instead of .3mm? The two make a world of difference in melanoma. Timing has been studied and shown not to have any difference in outcome except angst for the patient. But I'd first request a copy of my pathology report so I could know exactly what I'm dealing with. If this is .3mm, then there is no need for a sentinel node biopsy. If it is 3mm, then a sentinel node biopsy is needed and therefore, a different doctor. Finding this out now could help with any future delays later.
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- January 30, 2017 at 8:47 pm
I want to thank all of you for responding so fast to my original post "what to ask the dermatologist"? . You have put me on the fast track for my frien and I am on the fast track to getting him an appointment for the surgical oncologist. Several of you suggested for me to post the details of the dermatologist's report and I just got it from the hospital. Can you please help me understand the details please and what it means in regards to the stage the melanoma is in ?
Specimen:
A: 1172535. Right temple
B: 1172536. Left ChinRelevant Clinical Data:
A: Recurrent Neurofibroma
B: Pigmented nevusMicroscopic Diagnosis:
A: Malignant Melanoma: histologically amelanotic
B: Melanocytic nevus – Intradermal typeDescription:
Specimen A is a shave biopsy that in the papillary dermis shows some fine fibrils with small spindled nuclei that have no nuclear atypia. However, in the reticular dermis, there is a well-circumscribed neoplasm consisting of nested atypical cells without melanin pigment. These cells are epithelioid appearing, basically round with round to oval nuclei. The mitotic rate is 0 to 1 mitoses per mm2. There are very few tumor infiltrating lymphocytes. There is no evident intravascular invasion by atypical cells. The overlying epidermis has no evident atypical melanocytes.
Specimen A demonstrates:
A histologically amelanotic malignant melanoma. The neoplasm extends to the base of these sections and the tumor thickness is at least 3.6 mm confirming immunostains, namely vimentin, MART1 and s100 were positive for these cells.
Specimen B is a shave biopsy of a papule that has a normal epidermis. In the characteristics as they proceed deeper.
There is no nuclear atypia.
There is no evidence of dysplasia or malignancy in specimen B.
END.
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- January 30, 2017 at 8:47 pm
I want to thank all of you for responding so fast to my original post "what to ask the dermatologist"? . You have put me on the fast track for my frien and I am on the fast track to getting him an appointment for the surgical oncologist. Several of you suggested for me to post the details of the dermatologist's report and I just got it from the hospital. Can you please help me understand the details please and what it means in regards to the stage the melanoma is in ?
Specimen:
A: 1172535. Right temple
B: 1172536. Left ChinRelevant Clinical Data:
A: Recurrent Neurofibroma
B: Pigmented nevusMicroscopic Diagnosis:
A: Malignant Melanoma: histologically amelanotic
B: Melanocytic nevus – Intradermal typeDescription:
Specimen A is a shave biopsy that in the papillary dermis shows some fine fibrils with small spindled nuclei that have no nuclear atypia. However, in the reticular dermis, there is a well-circumscribed neoplasm consisting of nested atypical cells without melanin pigment. These cells are epithelioid appearing, basically round with round to oval nuclei. The mitotic rate is 0 to 1 mitoses per mm2. There are very few tumor infiltrating lymphocytes. There is no evident intravascular invasion by atypical cells. The overlying epidermis has no evident atypical melanocytes.
Specimen A demonstrates:
A histologically amelanotic malignant melanoma. The neoplasm extends to the base of these sections and the tumor thickness is at least 3.6 mm confirming immunostains, namely vimentin, MART1 and s100 were positive for these cells.
Specimen B is a shave biopsy of a papule that has a normal epidermis. In the characteristics as they proceed deeper.
There is no nuclear atypia.
There is no evidence of dysplasia or malignancy in specimen B.
END.
-
- January 30, 2017 at 8:47 pm
I want to thank all of you for responding so fast to my original post "what to ask the dermatologist"? . You have put me on the fast track for my frien and I am on the fast track to getting him an appointment for the surgical oncologist. Several of you suggested for me to post the details of the dermatologist's report and I just got it from the hospital. Can you please help me understand the details please and what it means in regards to the stage the melanoma is in ?
Specimen:
A: 1172535. Right temple
B: 1172536. Left ChinRelevant Clinical Data:
A: Recurrent Neurofibroma
B: Pigmented nevusMicroscopic Diagnosis:
A: Malignant Melanoma: histologically amelanotic
B: Melanocytic nevus – Intradermal typeDescription:
Specimen A is a shave biopsy that in the papillary dermis shows some fine fibrils with small spindled nuclei that have no nuclear atypia. However, in the reticular dermis, there is a well-circumscribed neoplasm consisting of nested atypical cells without melanin pigment. These cells are epithelioid appearing, basically round with round to oval nuclei. The mitotic rate is 0 to 1 mitoses per mm2. There are very few tumor infiltrating lymphocytes. There is no evident intravascular invasion by atypical cells. The overlying epidermis has no evident atypical melanocytes.
Specimen A demonstrates:
A histologically amelanotic malignant melanoma. The neoplasm extends to the base of these sections and the tumor thickness is at least 3.6 mm confirming immunostains, namely vimentin, MART1 and s100 were positive for these cells.
Specimen B is a shave biopsy of a papule that has a normal epidermis. In the characteristics as they proceed deeper.
There is no nuclear atypia.
There is no evidence of dysplasia or malignancy in specimen B.
END.
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- January 31, 2017 at 2:37 am
If it was a 3 mm, and not a 0.3 mm, especially on the face waiting unil the end of March is very irresponsable. My tumor was 0.94 mm, and in less than a month from the original biopsy I had the diagnosis, both surgeries done and the result of the lymph node biopsy on hand.
I would definitely push for a much earlier approintment.
Also, I had a plastic surgeon as well, my clinic worked with him for melanoma cases and mine was on my back.
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- January 31, 2017 at 2:37 am
If it was a 3 mm, and not a 0.3 mm, especially on the face waiting unil the end of March is very irresponsable. My tumor was 0.94 mm, and in less than a month from the original biopsy I had the diagnosis, both surgeries done and the result of the lymph node biopsy on hand.
I would definitely push for a much earlier approintment.
Also, I had a plastic surgeon as well, my clinic worked with him for melanoma cases and mine was on my back.
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- January 31, 2017 at 2:37 am
If it was a 3 mm, and not a 0.3 mm, especially on the face waiting unil the end of March is very irresponsable. My tumor was 0.94 mm, and in less than a month from the original biopsy I had the diagnosis, both surgeries done and the result of the lymph node biopsy on hand.
I would definitely push for a much earlier approintment.
Also, I had a plastic surgeon as well, my clinic worked with him for melanoma cases and mine was on my back.
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