I am 48 years old and a biopsy was performed on a mole on my left buttock. The dermatopathologist’s impression on the report was “Atypical Melanocytic Proliferation, favor a severely atypical compound dysplastic spitz nevus variant, extending focally to one lateral margin.” In the comment section following, he said he considered spitzoid malignant melanoma but it was “less favored.” The recommendation was 5-10 mm re-excision in all directions. My dermatologist performed a 10 mm excision. A pretty big excision from what I understand. This is my first diagnosis of anything like this, although my mother has had melanoma. After quite a bit of research, I am a little unsettled with this diagnosis. For my age, this seems like a very risky and very rare diagnosis. The follow up shows clear margins and the excision was certainly adequate. My only query is whether or not to have a sentinel lymph node biopsy or get a second opinion. Atypical Spitz rarely occurs and very very rarely occurs in adults. Thoughts?
I would definitely get a second opinion on the pathology, or maybe two opinions. You can have the slides shipped. I would send to Boris Bastian, last time I checked he was back at UCSF, and Marty Mihm (http://www.drmihm.com) you should be able to get a definitive report between these experts. Spitzoid nevus are normally benign and not melanoma. So let us know what the experts say.
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