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  • #20525
    BDK2727
    Participant

    First off, just want to say that I have NOT been diagnosed with melanoma. Hope its okay that I post in this forum. Im just really nervous and would like to explain my situation and get some feedback. I had a biopsy on 7/24 and got the results back today; no cancer evident but the results were not exactly clearcut. My primary doc said I need to get a “wide excision” and more tests done, but there was “nothing to worry about”

    Here is the pathology report:

    “Micro Description: The sections show a circumscribed, symmetric compound nevus characterized by nests of nevus cells at the dermal-epidermal junction, primarily at the sides and tips of rete ridges, and nests in the underlying dermis. There is architectual disorder consisting of irregularity in the size, shape and distribution of the nests at the dermal-epidermal junction and bridging between rete ridges. There is marked cytologic atypia in some nests at the dermal-epidermal junction. There is no significant pagetoid growth and the dermal component shows maturation. The lesion extends the lateral margins.

    The dermis shows significant fibrosis and inflammation. Some of the nevus cells within the dermis are rather large and have eosinophilic cytoplasm. Additional studies are performed in order to ensure that the lesion does not represent melanoma and the MITF-1 stain shows no significant melanocytes above the dermal-epidermal junction while p16 staining shows strong staining in the dermis and Ki-67 does not show prominent staining in the dermis aside from staining noted in whate are interpreted as lymphiod cells. This may represent an irritated Spitz nevus and since it is present at the margins consideration should be given to an excision.

    Diagnosis: Inflamed compound nevus with architectural disorder and severe junctional cytologic atypia (Dysplacstic nevus withe severe atypia) extending to the lateral margins.

    Soooo… What does this all mean??? Do I definitely not have cancer? Is it possible to turn into cancer? Any opinions and advice would be greatly appreciated!

    And PS to you all: Good luck with your own personal struggles. As stressed out as I have been lately I know you all have it 100 times worse. Take care and thanks for any comments!

    Brian

    #55747
    Catherine Poole
    Keymaster

    You are right, you do not have melanoma. This was a dysplastic or atypical mole that probably didn’t need to be removed. But it may have looked suspicious. Your pathology report doesn’t show anything that is of concern. But if you have a lot of atypical moles, you should continue with frequent skin exams and possibly whole body photography.

    #55748
    Worrywart
    Participant

    Hi there,

    The lesion shows some features of melanoma, although not enough to classify it as a cancer. I’d probably get another opinion, just to be safe.

    good luck!

    #55749
    Catherine Poole
    Keymaster

    What features are you referring to Worrywart? Severe atypia isn’t melanoma. Spitz nevus is a possibility and if this person is young, than more probable. A second opinion is always a good idea and just means sending your slides to someone expert at a teaching institution or cancer center known for melanoma.

    #55750
    Worrywart
    Participant

    I was told that melanoma in situ is diagnosed based on the pathologists determination of how severely atypical a lesion is. Features such as pagetoid spread, architectural disorder, fibrosis and inflammation in dermis, and marked cytologic atypia are all typical in melanoma in situ. Basically, what one pathologist calls severely atypical, another might view as melanoma in situ. Also, the fact that spitz comes up in path report makes me think another look wouldn’t hurt.

    #55751
    Catherine Poole
    Keymaster

    Yes, a spitz nevus is very difficult to discern and I would recommend a second opinion by an expert. However, atypical doesn’t mean melanoma, and the pathologist would need to call out melanoma (a definitive malignancy whether early growth or not) and it isn’t called out here. The level of dysplasia sometimes gets you closer.

    #55752
    cohanja
    Participant

    I’ve had some of those features in path reports of mildly atypical/mildly dysplastic.

    #55753
    Worrywart
    Participant

    Catherine, I agree with you…but I like to cover all the bases, which is why I always recommend second opinions.

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