Tset

I have had a similar situation. 8 years ago I was diagnosed with Lentigo Maligna/Melanoma in Situ. Had a wide local Excision and assumed all would be well. Went every six months for skin checks after that. Exactly 4 years later my derm removed a small spot that was right beside scar and a little bit of it was on the scar. It had been there for some years but it looked like a small freckle so nothing of concern. It came back as a recurrence of Melanoma Insitu. I didn’t understand how it could come back 4 years later as in Situ again. I figured it would be invasive. The specialist said my type can have long tentacles that need more margins cut than normal and that some cells had been left behind and grew back. I had MOHS after that since it was still insitu. Now 4 years after that I have a spot beside the scar yet again. Looks a lot lighter than the last and may not be anything but I’m having it checked out to be safe. It does happen and I found also there’s just not a lot of info on that type of situation. I hope all turned out well for you.

I had a spot that looked like a freckle come up on my scar. Assumed it was a freckle but it appeared sometime within the first year of WLE. My original melanoma was a Melanoma in Situ( Lentigo Maligna type). 3 and a half years later it got a little bigger so derm removed it. Path came back saying it was a recurrence and was again Melanoma in Situ. Not sure how it didn’t come back invasive but I was told it was likely they didn’t remove enough the first time so rogue cells were left behind. Treatment was the same as original since it was still considered In Situ, WLE. I would think treatment would be whatever the standard treatment is for the type and depth of recurrence if a recurrence is what it is. Could be nothing though. I have a few pigments freckles on and around my scar that are nothing, just from the sun. Cheers, Tenisa

Back in April of 2018 I had my 6 month skin check. I have freckles on my chest area where I had a Melanoma in Situ removed 3 and a half years prior. I had what looked like a freckle in the middle of my scar and a small part of it was on the regular skin. My derm wanted to remove it because it was on the scar and did get just a little darker from the last time she checked months ago. She really didn’t think it was anything because it looked like a light tan freckle. Going back through pics the freckle wasn’t there after my WLE surgery but it was there in my 1 year post WLE photo so it popped up sometime within that first year. The path report came back and said it was a recurrent Melanoma in Situ. Talk about a shock. I couldn’t understand how a melanoma in Situ could come back and that it came back again as Melanoma in Situ. Went to Duke where they have a melanoma specialist and they re did path reports on the original MIS, the WLE as well as the new MIS that was on my scar. They wanted to make sure there hadn’t been a mistake on the previous pathology as it’s not common to return and more rare for it to return as another Melanoma In Situ. There report matched up and they explained it as some cells were left behind in my WLE. They said melanoma will sometimes have tentacles that extend beyond the mole and excision didn’t get all of it so it grew back. Mine is the Lentigo Maligna subtype and I guess that sometimes happens with that. I ended up getting MOHS surgery where he removed the entire scar plus quite a bit beyond that and made sure it was all gone before the sewed me up. Sent the scar etc to the lab for path and it came back clean so nothing invasive or lurking beneath thank god. If it were me I would err on the side of caution and just have them remove it and send it off to make sure it’s nothing. If I get any type of freckle or mole on this scar again better believe I’ll have them remove it to give me peace of mind. Hoping you get some answers when you see your derm. Best Wishes, Tenisa

From what I've been told is that if Melanoma spreads via lymph nodes that it usually spreads to the lymph nodes closest to the primary Melanoma. Would be unlikely to spread to the opposite side of your face. I had my first primary Melanoma 3 and a half years ago. It was a Lentigo Maligna(in situ) and was center chest. I had a WLE and everything came back clear margins and I was happy. Fast forward to April of 2018 the dermatologist removed a small freckle on my scar. It came back as a reccurent Melanoma In situ. I had a palaple lymph node in my left axilla that had been there for 2 years so I immediatly thought Melanoma. They did tell me the way lymph drains that center chest would drain most likely to either axilla. Had an ultrasound and they were actually normal size. Im thin so i can feel them more. I went to a melanoma specialist to make sure I didnt miss something. I mean MIS coming back as MIS again seems really strange. Basically I was told that Lentigo Maligna has a higher recurrence rate than any other subtypes and the typical margins are sometimes inadequaute for that type. They did the standard 5 mm or something with my first one and it wasnt enough. I asked, then how come I got clear margins. They said sometimes rogue cells can be left behind, the freckle/mole on LM alot of times has what they call tentacles that reach well beyond the mole. Also something with pathologists doing a technique called bread loafing where it slices the tissue like a piece of bread and sometimes some cells are left in the 'bread piece' that isnt looked at. Needless to say it was overwhelming. I opted to do a modified MOHS technique where he basically did a WLE, cut out the entire scar plus like 7 ro 8 mm outside of the scar and did the MOHS on the rest. Took 6 hours being it takes the stains a while to show melanoma cells but I got clear margins and didnt have to get any more cut so Im Melanoma free. My dermatologist said the past few years she has been removing between 7 and 8 mm margins for Lentigo maligna. When I had mine nearly 4 years ago they were still only doing the 5. I dont think that palaple node on the other side of your face has anything to do with Melanoma. If it were you would likely notice it getting bigger and bigger and it would probably get hard and unmoveable.. Melanoma in situ doesnt have the ability to spread unless theres a rare case like mine that cells were left behind. well wishes to you, Tset

Im not new to the forum but have been keeping up with it since 2014. You are such a breath of fresh air to everyone on this forum. Ive been keeping up with it since then and my second recurrence. When I see your posts it makes me smile. I hope you got good results from your PET scans. Thinking of you here in North Carolina. TSETZ

They called mine reactive as well but were still just a normal size. Ive read that too about LM. My dermatologist also said that many of them do not ever turn invasive but because they dont know who it will or wont they treat them all the same. I guess after almost 4 years mine grew back basically in the same spot give or take a mm and was still noninvasive. I was only 34 when I got diagnosed but I do have a sundamaged chest but I didnt think it was that bad. I told the MOHS surgeon to take out more if needed because if one of these cancer cells are left behind again I may not be so lucky next time. Its hard not to worry and it does make one paranoid for sure. We just have to stay postitve and live life to the fullest:)

I too have been the same way. When I was first told I had a melanoma in situ 3 and a half years ago I felt every lump and bump. I would wonder if my pathologists were correct on my diagnosis of MIS or if it was wrong. After I got it removed and time went on that fear became less and less and I no longer worried too much. I always became a bit nervous around my 6 month skin checks with the dermatologist but everything was usually fine. However, about a month ago my derm removed a small freckle looking type mole off my scar and it came back as a recurrent Melanoma in situ.. Those feelings came back and was a bit worse for me than the first time. I started questioning previous path reports and lumps etc. Had my path reports re done by another dermopathologist and they all matched up so it did give me some reassurance. Had an ultrasound of my axilla where I felt lumps but they were normal size and looked normal. I’m thin so I guess I can feel more lumps. It did help ease my mind a bit. I felt like I was going crazy though. I know I’m lucky that this came back as in situ because it could’ve just as easily have come back invasive being those cells were obviously left behind for 3 and a half years. As the weeks have went by the feeling like I’m crazy and feeling every lump and bump is slowly getting better. I will feel much better once they cut this out of me again but I know it will always be in the back of my mind. I think that is a normal way to feel once you’ve been told you have Melanoma. Just try and stay positive. I will be sending up prayers for you. All the best… Tenisa