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WLE for Spitz nevus
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WLE for Spitz nevus

› Forums › General Melanoma Community › WLE for Spitz nevus

  • Post
    • September 2, 2018 at 9:48 pm
    pnwander27
    Participant

      Hi everyone,

      I've been lurking for the past few weeks and have finally gathered the courage to post and hopefully gain some insight for my situation.

      I had a punch biopsy done two weeks ago by a dermatologist for a 4mm red lesion on my leg. The lesion had visibily been there since the spring (3-4 months), but I think it slowly started developing a year or so before. Long story short punch biopsy results came back a few days ago. I will copy them below: 

      Final Diagnosis: Junctional Spitz nevus extending to biopsy margins (see Comment).

      Final Diagnosis Comment: In this clinical setting, conservative re-excision is indicated to assure complete removal and to definitely exclude melanoma.

      I'm a 26 yr female so I do realize it's rarer for me at my age to obtain a benign Spitz nevus (but not impossible?). My dermatologist has been so very helpful and confirmed there was no cancer cells found in my punch biopsy, but that they want to do a wide local excision biopsy with a 5mm margin removal to ensure complete removal of the nevus (that can grow quite rapidly) and check the surrounding tissue.

      Does this sound about right? 

      I deal with health anxiety too so I'm just trying to stay on top of things and understand the situation to the best of my abilities, and you all seem very knowledgeable. 

      Thank you

    Viewing 2 reply threads
    • Replies
        • September 3, 2018 at 4:55 pm
        MelanomaMike
        Participant
          Hi Anonymous, i may be wrong but, didnt you already have a WLE and started treatment with PV10? Could be incorrect, there are a few Anonymouses here who are in same boat like you with the Spitz…
            • September 3, 2018 at 10:55 pm
            pnwander27
            Participant

              Hi Mike!

              No I'm a new account, I guess I could have posted from my username pnwander27. Wonder if I can change the post name to avoid confusion. Thanks for the clarification though. 🙂

            • September 3, 2018 at 10:49 pm
            KellyH
            Participant

              Hi anonymous. 

              My 17 year old son was diagnosed with melanoma in February 2018.  We were sent to Boston for  a second opinion by the local oncologist because Spitz Nevus and melanoma can apparently resemble each other so closely under the microscope that it  can be difficult to distinguish between the two. In fact we were told by the melanoma specialists in Boston that there are only a handful of centers in the US that could accurately diagnose the difference between them. My sons pathology was reviewed extensively by the team in Boston and after a lot of deliberation the team decided they were unable to reverse his melanoma diagnose with 100% certainty…there were just too many discrepancies in all his pathology samples. Therefore we are erring on the side of caution and he began treatment for Stage 3a melanoma in May 2018.  

              My advice to you is to see a melanoma specialist…not just a dermatologist.  Have all your pathology samples sent to a melanoma team for analysis and a thorough review. The team in Boston left no stone unturned and I am very comfortable with the treatment my son is getting. My son has an excellent prognosis and I owe that to the melanoma specialists in Boston. I am forever grateful. 

              Melanoma is tricky…And you need to be one step ahead if possible.  You may have a Spitz Nevus and I hope the dermatologist and the original pathology report are accurate. That is definitely a possibility…but it is also possible that it is that sneaky melanoma. 

              I am sorry you are going through all this but I am glad you found this forum…there are many educated people on here fighting melanoma for years and are NED after being Stage 4!!! There is so much hope and so many new treatments….but you need a melanoma specialist to diagnose you accurately. 

              Good luck!!! 

              Kelly 🙂 

               

                • September 3, 2018 at 11:25 pm
                pnwander27
                Participant

                  Hi Kelly,

                  Thank you for your reply! I'm happy to hear your son has an excellent prognosis and that you were able to catch it. I've done some research on Spitz nevus and it's scary that they can so often go undiagnosed. I'm hoping my WLE biopsy will give me more information after this Friday. If you dont mind me asking, what type of biopsy did your son originally have and did it come back as a normal benign Spitz nevus at first? 

                  I'm in BC, Canada and am unsure of where to look for melanoma specialists. Our healthcare system is a little different, but I will try getting my pathology slides sent down to a specialist in the States. I'm really new to all of this. If anyone in Canada can recommend a melanoma specialist, or on how to obtain my pathology slides and have them sent, I would so appreciate it!

                  Thanks again for your advice and sending you love,

                  pnwander27 🙂

                  • September 4, 2018 at 12:23 am
                  KellyH
                  Participant

                    My son had a mole removed from his scalp by a pediatric plastic surgeon that several other doctors looked at including the dermatologist, and no one was overly concerned. It was a routine mole removal and the pathology cameback malignant melanoma.  The pediatric plastic surgeon sent us to a Head and Neck oncology surgeon for a WLE and a sentinel node biopsy.  When his sentinel node came back  positive for microscopic melanoma, we saw the oncologist who sent us to Boston to see Dr. Flaherty…he is one of the top melanoma specialists in the US. Our oncology team wanted his pathology reviewed because there were some characteristics in his pathology that could indicate Spitz Nevus and not melanoma…apparently it is that difficult to distinguish between the two for pathologists that do not routinely review melanoma slides.  

                    We did travel to Boston, it was a quick day trip for us. Prior to our trip, I had to call the hospitals where my sons original surgeries took place to have his tissue samples sent to Boston…it was a bunch of phone calls on my end but the process was pretty easy. I had to sign so releases but I was able to fax them over. 

                    It took 2 weeks following our initial visit for the Boston team to thoroughly review all my sons tissue samples and slides…and although they said although it could still be possible this is Spitz Nevus there are too many discrepancies to call it one way or another…they felt that we needed to treat it as if it is melanoma.  And because he had a positive sentinel node (which is very common in Spitz Nevus) he is considered Stage 3a melanoma. 

                    I Know your healthcare system is very different than ours…so I hope someone in Canada can help you navigate and get you to a melanoma specialist for their opinion. Dr. Flaherty is amazing and I know my son is in great hands because he is one of the best in the field of melanoma. 

                    I hope this helps!!!!  Again good luck!!!! This is not a journey anyone intends on going on but there is a lot of support out there!!!! You are not alone. 

                    Kelly 🙂 

                    • September 8, 2018 at 3:27 pm
                    pnwander27
                    Participant

                      Thank you for the knowledge and insight Kelly, I think it's super important to be educated about this. Glad you were able to seek the best care you for your son. Hope you both are doing well and sending love!

                      • September 4, 2018 at 7:57 pm
                      Janner
                      Participant

                        UCSF (San Francisco) also specializes in Spitz and is closer to BC – more logical west coast choice.  I'd contact them to send your sample if you go that route.

                        • September 8, 2018 at 3:22 pm
                        pnwander27
                        Participant

                          Yes, thank you. I've reached out to them and inquired with my derm about obtaining slides for a second opinion. Had my WLE done yesterday so will wait for results on that before moving forward. Thank you for the advice. 

                        • September 6, 2018 at 1:30 am
                        AN8
                        Participant

                          My 22 yr old daughter had a punch biopsy of a lesion that came back junctional spitzoid melanocytic lesion.  Full excission recommended and resubmission for a second look.  Second path came back benign junctional spitzoid.  They tested for the p16 tumor suppressant gene ..which was present and an indication of a benign lesion.  I had just been diagnosed stage 1b 3 weeks prior.  Talk about nerve racking!!!  She will now be followed every 6 months by derm for a while bc of the atypical spitz and my genetic influence.  So it can be ok. IF the 2nd look comes back positive for melanoma it should be an early stage ..that is what the derm told my daughter.  I hope this gives you a little peace of mind and pray for the best.

                            • September 8, 2018 at 3:24 pm
                            pnwander27
                            Participant

                              Thank you so much. Sorry to hear you've been dealing with so much at once! Thank you for the advice and knowledge. Will wait for the WLE biopsy results and go from there, just had that done yesterday. Hope you're hanging in there. 

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