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QuietPoet

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      QuietPoet
      Participant
        Ditto what Bubbles says. Always worth a re-check. I had the exact same thing going on in my left thigh plus a lump behind my knee. Turns out the mole was somewhere in between a Spitz Nevus and a melanoma (not a melanoma but could go that direction), so they recommended re-excision as if it were a melanoma. Got a fine needle aspiration on the lump. Turned out to be a lipoma. For piece of mind, it’s good to have it checked even if it doesn’t turn out to be melanoma again.
        QuietPoet
        Participant
          As AlmostAlice says, pictures can be very helpful. Many times we can unknowingly pinch or bruise our toenails. If the black mark moves up your toenail but doesn’t continue to stay at the bottom as it grows (and sometimes this happens slowly) you’ll know it’s just a bruised toenail. I freaked out about this, too, since I have had melanoma. But, taking the pictures two weeks apart showed me that it was moving. Only a pinched toenail, which was fixed by a new pair of hiking boots. Most likely a similar scenario is the case for you.
          QuietPoet
          Participant
            Hi Duane,

            I’m pretty much in the same situation as you. Mine wants to remove mine because it’s very close to the original melanoma and it’s perhaps a little more than moderately dysplastic (so I am going to have the WLE) just to be on the safe side because this mole was changing. You could ask your dermatologist why they would suggest removing it. Since a biopsy has already been done, it’s probably a little hard to watch and wait because it might not be so easy to see changes, so perhaps that’s why they are suggesting removing it. If you remove it, you’ll never have to worry about it again.

            QuietPoet
            Participant
              Thank you, again, Celeste.

              Still, though I have yet to have the opportunity, if I am ever asked, “Have you been at Harvard?” I will say, “Why, yes! I have!”)

              That’s hillarious!

              In any case, I now feel armed with the right questions thanks to you. Onward!

              Erika

              QuietPoet
              Participant
                Thank you, Celeste. That’s helpful. One more question if you don’t mind. Since spitz tumors do commonly metastacize (spelling?) to lymph nodes, and of course melanomas can too, but the outcome between the two if they metastacize is very different, if the doctor did do an SNLB, would they be able to tell if Spitz cells or melanoma was in the lymph nodes? I normally go to UCSF, and I realize they are pretty advanced in their pathology in this area, but I haven’t been able to find anything about someone with both types of growths in the same area. Apparently if Spitz gets to the lymph nodes, it’s probably not that big of a deal, but of course if melanoma does, it is a big deal in terms of how to manage it.

                I have only been able to get part of the information from the pathology report from this latest round, so I don’t even know if they would do an SNLB for a Spitz of this depth. I don’t know the mitotic rate or whether it was ulcerated. Below is the path report if that’s helpful. I don’t know if my age makes any difference either, but I am 54. Maybe I’m just getting myself worked up, and really another WLE is all that’s needed. I think it’s the proximity of the two that has me concerned in terms of whether there are any other melanoma cells floating around in there. It’s going to look like I have railroad tracks once the second WLE is done.

                Thank you again.

                Component Your Value Standard Range Flag
                ICD9 Code 238.2
                Clinical Text 6 MM CHANGING NEVUS; R/O CHANGING NEVUS
                Final Diagnosis LEFT LATERAL THIGH
                COMPOUND MELANOCYTIC NEVUS, CLARK’S (DYSPLASTIC) TYPE, RE-EXCISION RECOMMENDED
                Diagnosis Comment The findings favor a dysplastic (Clark’s) nevus with spitzoid cytological features, and perhaps even a thin atypical Spitz tumor. The neoplasm extends to within 1 mm. of the peripheral edges of the specimen. A re-excision with 3-5 mm margins seems
                prudent.

                Details regarding the work-up performed to date in our laboratory follow below:

                Staining with the VE1 antibody, which recognizes the V600e mutant form of BRAF is negative. A positive stain would have put the lesion outside of the Spitz lineage, as defined in the 2018 WHO classification.

                A p16 immunoperoxidase stain shows adequate expression of tumor suppressor gene product (nearly complete or complete absence of staining in a defined zone is worrisome for melanoma).

                A PRAME immunostain is negative. Strong, uniform staining of the nuclei of the lesional melanocytes would have favored melanoma.

                Cylindrical skin segment, 0.8 cm in diameter and 1.0 cm in thickness, with the margins inked, trisected and entirely submitted with fragments. BY/BY

                Microscopic Description: There is a proliferation of melanocytes involving the epidermis and superficial dermis, with elongated rete ridges, increased numbers of single, cytologically bland melanocytes at their sides and bases, and melanocytes with variably abundant cytoplasm and variably enlarged and heterochromatic nuclei in the superficial dermis.

                QuietPoet
                Participant
                  A CT and a PET scan are different.

                  A CT scan, I would think — someone with more knowledge please correct me if I’m wrong — can only indicate masses and the like. PET scans indicate “energy activity” (i.e., it measures something that is active rather than static), so it could probably discover more accurately current LN involvement. This is because PET scans measure activity through what areas of the body consume the chemical.

                  QuietPoet
                  Participant
                    Hello, Ann:

                    I have a lot of moles too, on my arms, especially. The thing that has helped me is to take pictures (or have someone you’re comfortable with take pictures) of your various body parts not too close and not too far away. Then you can look and see if they seem to change over time. Also, if one of them starts to bother you in some way (itching, etc.) go to a dermatologist and have it looked at. Finally, have a skin check done by a dermatologist once a year. I hope that helps!

                    QuietPoet
                    Participant
                      Hi Stephen Anthony:

                      Welcome! You are probably focusing on the worst case scenario. Most likely it’s not melanoma, but if it is, and it’s caught early, you should be in good shape. I had a 1A taken out four years ago, and all has been well since. I just stick around and try to calm the fears of new people here who aren’t already in the trenches with this. And reading everyone’s post makes me want to see that their stories came out okay — and nowadays, they come out okay more and more. But that is if it is melanoma.

                      Waiting is the hardest part, as Tom Petty said. Try to take a deep breath, and just wait to see what the doctor says and do something you enjoy to get your mind off the waiting. Hopefully you’ll find out soon. Chances are, though, that it’s just a melanocytic nevi (a mole), and that’s it. Take good care, and let us know how it turns out and if you need any help with the lab results when they come along.

                      Best,

                      Erika

                      QuietPoet
                      Participant
                        Hi Nandi:

                        I’m in my 50s and am still getting new, benign moles appearing — mainly on my sun-exposed arms though. I always get them checked because it’s better to be safe than sorry. Waiting is the hard part, and I hope you hear back soon.

                        All the best,

                        Erika

                        QuietPoet
                        Participant
                          Thanks, Christian. I appreciate the link. I will check that out.
                          QuietPoet
                          Participant
                            This is just what I was looking for. Thank you, slholmdahl. I appreciate it.
                            QuietPoet
                            Participant
                              So, it looks like it hasn’t entered the depth invasion stage, and it’s only spreading in the top dermal layer (this is good!) It means it’s “in situ” so its Level 0. Get a WLE (wide local excision) now before it starts going deeper. You will never probably have to worry about it again, and the depth of the WLE won’t be that bad. Great news!

                               

                              QuietPoet
                              Participant
                                Hi Jess,

                                I’m at 1A. My derm insists on an every 6 month check, but yearly is the norm if you haven’t had it yourself. 1 minute check? That’s absurdly short. Yes — check the scalp and face. I would go with a full-on derm. given your family history. Your gut is telling you to do that, it sounds like, so I would go with it.

                                QuietPoet
                                Participant
                                  Hi Chelem2:

                                  I know this can be very anxiety producing, but there’s no way to know what anything “means” until you receive your report. Did you ask your doctor’s office when you can realistically expect it at this point? Statisticaly speaking, it’s unlikely to be anything to worry about. I’ve had four moles (some of them very worrysome looking) biopsied since my 1A three years ago, and nothing has even come back worse than a dysplastic nevi. You will be okay. Just try to breathe. And let us know what happens when you get your results. Take care.

                                  QuietPoet
                                  Participant
                                    I just read an article in today’s USA today that cited my dermatologist saying that small bumpy rashes are a rare side effect of COVID-19. If testing is available for you, you might consider it, just in case.
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