How to tell the difference
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I have a lot of lipomas all over my body. How can one tell the difference between something benign like that vs for instance, a melanoma tumor? Lipomas are fatty benign tumors. With a .3 breslow melanoma, it is highly unlikely you would have melanoma tumors. I’m not sure what you are asking. We all have to pay attention to our bodies and bring up any concerns to doctors, etc. . but with lipomas. . some of which I’ve known I have had for a long time, some may be newer or I didn’t know I had at that particular part of my body, etc. . and I can’t run to the doctor everytime, so I’m wondering how you can tell al lipoma from something more serious. . is the feeling different, look different, act differently? Also, it may not be so unlikely. . I’ve heard here over again that melanoma is unpredictable, doesn’t behave, any melanoma with depth/invasiveness can spread, etc.. and going by the one study by Guerry, etc. . that had the 4 risk categories of thin melanomas. . male/VGP/MR>0. . risk is about 30%. . so, I have to pay attention to things, and these lipomas worry me because I feel I might just assume something is a lipoma when it may be something different, such as melanoma I have a couple lipomas. I think you would have an idea if a growth was another lipoma or a cancerous tumor. A cancerous tumor would likely grow and change, just like all cancer. It would also probably be harder than a lipoma and stand apart as a different growth. However, you didn’t have Vertical growth phase or mitotic figure, just a shallow .3. But certainly you can get things checked that could be something else altogether. I know the study well and Dr. Guerry was my co-author on the book I wrote about melanoma and he trained me in this area pretty well. So unless you come up with vertical growth phase, you are highly unlikely to have metastatic melanoma. Is Dr. Mihm checking out your pathology? I’m in the process of sending Mihm the pathology material. Yes, I did have VGP. University of Chicago identified a dermal mitotic figure, so they said VGP. MD Anderson did not identify any dermal mitoses, but said VGP due to the size of dermal nests. So, whether due to dermal mitoses and/or size of dermal nests – I did have VGP. Thin, yes, but still VGP. will be interesting to see how Mihm’s report squares with the others. I had VGP, ulceration and mitosis, but still the thin melanoma is what saved me. Am I repeating myself? Yes, I am aware of your pathology, and it’s good it was thin. As has been said on this forum many times, though, each of us is different, an individual, and each individual melanoma case will behave differently in each of us. Cases that you’d think would spread didn’t, and ones you wouldn’t think would spread did. I think we can find examples of everything – thin ones that metastasized, thick ones that didn’t, etc. . Actually, that hasn’t been said in a literal fashion, true we are not statistics but people. What has been emphasized is that a lesion that is shallow depth or thickness is highly unlikely (and nearly biologically impossible) the ability to spread. What has happened when lesions that were low risk did spread was an error on the pathologist’s end. So we always suggest an expert check your pathology. You’ve had two reports and the third should hopefully give you peace of mind. Ok, maybe I misunderstood what has been said here before. I thought what was said was that lesions in RGP is nearly biologically impossible to have the ability to spread – so, not based on thickness, but based on characteristics such as growth phase, mitosis, etc… Although my lesion was thin, it exhibited VGP characteristics, so I thought that is what gives it the biological ability to spread, regardless of depth. I didn’t realize that even with VGP, shallow depth lesions are still unable to spread. Also, to note, with regard to depth, my lesion did exhibit focal regression. Now, I know Dr Mihm said that only extensive regression has shown to be prognostically significant, not focal regression. But, still, the lesion could have been deeper focally at one time than is seen in the pathology that says 0.3mm.
On a totally different note, I was watching the olympics yesterday and during the mens beach volleyball match, they said one of the U.S. players, Jake Gibb, had an early stage melanoma removed from his shoulder a few years ago (they mentioned that in the context of the more recent testicular cancer he had in 2011).
This is Mihm’s report: Malignant melanoma, superficial spreading type, invasive to level II and a measured thickness of 0.3 mm. Close to lateral margin. This lesion, in my opinion is definitely a malignant melanoma. It is microinvasive and it is in radial growth phase. I find no mitoses, no evidence of true ulceration or regression. I consider the lesion to be a pT1a. I would suggest a re-excision with 1.0 cm. margin.
Obviously, I had the re-excision with 1 cm margin a year ago.
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