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Tset

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      Tset
      Participant

        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

        Tset
        Participant

          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

          Tset
          Participant

            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

            Tset
            Participant

              She did remove it and send it off for biopsy. So now I wait.

              Tset
              Participant
                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
                Tset
                Participant

                  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:)

                  Tset
                  Participant

                    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

                    Tset
                    Participant

                      Thanks for your input Janner. It seems as if this MOHS surgeon would be doing basically a wide local excision but using the MOHS technique to make sure none of the tentacles of melanoma are left behind. He also mentioned that pathologist use something called a breadloafing technique while examing wide local excisions im which they slice it like a loaf of bread to check for cells. He says that is fine in the majortiy but in some people there are cells in between those slices that arent seen.He said that the wide local excision part would not be done that way with his MOHS surgery that they look at the entire tissue to make sure nothing is left behind. It sounds like to me that would be a better option than wide local excision alone on any melanoma lesion especially since a normal derm, plastic surgeon or surgical oncologist would only do a wide local excision with maybe a little wider margins and then when they send that off to path the breadloaf the tissue which can leave cells. Do you have any idea why that wouldnt be recommended for melanoma beyond in situ being he is still doing a WLE and he said he cuts down to the fat? My origional in situ was a LM subtype in situ but even it was really small. This recurrence is even smaller than the origional literally the size of a freckle and looked like a freckle. Ive gotten mixed reviews, an oncologist I spoke with said dont do mohs and the surgical oncologist at duke said thats fine with insitu but not if path report comes back saying not really in situ but thin. Ive talked to 3 different dermatologists and they all recommended MOHS. Its just so confusing.

                      Tset
                      Participant

                        Your right Janner. Thank you :)

                        Tset
                        Participant

                          I went back and looked at pics and it wasn’t there a few weeks after my first wide local excision. I saw it in a photo that was taken 1 year later and it was there. That thing has been growing for at least 2 and a half years. The more I thought about it the more it freaked me out. Here’s one thing I forgot to mention and I wanted to ask your opinion on this and whether you have ever heard of this. 6 months ago I had my skin check. I noticed a tiny little black dot on this same freckle/mole. I was scared thinking was melanoma but the derm checked it out and said it was not that it was a plugged hair follicle. She used a little stick like thing and just popped it right out. The dot was gone and I thought all was well. Now this is the same freckle/mole that was on my scar and that she removed because it was getting a little darker( not that I could tell anyway).  The path report that I wrote above mentioned something about cells in the hair follicle but it was diagnosed as a recurrent melanoma in Situ. Now I’ve just freaked myself out thinking about it. Could that have been melanoma she popped out thinking that was a plugged follicle, is that even possible to do with melanoma, wasn’t sure if it would just pop out? Now I’m rethinking everything. Sorry for the long reply. TSET

                          Tset
                          Participant

                            That makes sense. My derm refered me to a MOHS surgeon and said that may be the way to go since this is on a scar. It is right in the middle of my chest and the scar looks like I had heart surgery, lol. Im not at all concerned about this leaving a worse scar, I just want to make sure this crap is out of my body.

                            Tset
                            Participant

                              Janner, thank you so for your kind words. I thought melanoma in situ couldnt be a recurrance as It would grow from the inside out. It seems odd that I have had this freckle there from a few days after my origional WLE. Maybe it just started growing in there. Do you think I should have a SLNB before I get this excised even though im insitu? If This was melanoma in the two nodes on the side of left breast wouldnt the nodes be increasing in size?

                              Tset
                              Participant

                                Thanks for the response. I went to the dermatologist and she said it was a plugged pore. she got it out and i was relieved. However, It has been 6 months and i had my 6 month skin check. She noticed the same freckle looked a little darker on one side that wasnt there 6 months ago. If this is melanoma would it be considered another primary since It was a freckle that was on the scar or would it be a reccurrance? Thanks

                                 

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