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August 19, 2013 at 4:21 pm #21532
I have just flown in to California from the western Pacific. Had an excisional biopsy from left forearm come back as atypical nevoid (nodular?) MM. Left the U.S. 9 years ago cruising on my sailboat and I do not have any established doctor here, just the recommendation from the doctor on the tiny Micronesian island I was on to fly back to the U.S. and have this evaluated/treated.
Can I get some advice on the best imaging/testing to see how far this has spread or not? (Both locally around the lesion, and to detect distant metastases?)August 19, 2013 at 7:31 pm #62238
Depending on how deep the melanoma is (Breslow level) you may be asked to have a Sentinel Node Biopsy, this will tell you if the disease has spread beyond the site to the lymph nodes. However, there really is no imaging to tell you if microscopic disease has spread in the body. Pet and Cat scans are used to determine more major growth of disease, tumors that may have formed which is doubtful. What did your pathology report read? Did it say nodular? What depth? Mitotic factor? Please see our page on Sentinel node biopsies for further info too: http://melanomainternational.org/melanoma-facts/sentinel-node-biopsy/#.UhJynPXD-t8
.August 19, 2013 at 8:41 pm #62239
Thank you for feedback Catherine,
Report says Breslow 0.2cm, Clark’s IV, Infiltrating Lymphocytes present, non-brisk, Mitotic count <1/mm2.
Pathologist says it’s a Malignant Nevoid Melanoma.
But the lesion was a pink, smooth, not friable and not ulcerated lesion. I did not have a nevus there before.
Now I have pink smooth scar tissue, but steadily growing brown macular lesions are extending from where the single simple suture came up through the skin. It’s scaring the crap out of me.
Part of the difficulty I suspect was a delay in sending the tissue for analysis, biopsy was done on 06-June, but not received by path lab in Hawaii until 13-July. I work for a disaster relief organization covering the Micronesian nations of the FSM and Marshall Islands. I was away on a ship delivering food relief supplies and did not find my doctors’ email until I got back in from sea.
Is the sentinel node biopsy really that accurate and predictive? I understand it is dye and isotope directed to find the node, but it still seems a bit random to me. Can’t mets pass through the sentinel node and go further downstream or travel by way of red blood vessels instead of lymph? I will read the link you have provided.
Thank you again for your response, I am trying to get in for further evaluation here, hopefully this week sometime.August 19, 2013 at 11:17 pm #62240WorrywartParticipant
Was this a 2mm lesion?August 20, 2013 at 1:20 am #62241 Report says 0.7cm X 0.5cm lesion dimensions with Breslow thickness measurement of 0.2cm.August 20, 2013 at 12:14 pm #62242 So that sounds like a low risk lesion. Please do get it evaluated at a place of melanoma excellence. Where are you now?? Thank you for your great work! You can call me as well if you are in the states, toll free: 866-463-6663August 20, 2013 at 12:16 pm #62243cohanjaParticipant Is this 2 mm ?August 20, 2013 at 2:38 pm #62244 The biopsy reports it as 0.2 cm deep, so I assume it is 2.0 mm, but it does not go out to that decimal place.
I am in southern California, L.A. area, going to go to City of Hope Cancer Center today and see what they can offer. Will try to call today and get your advise, thanks.August 20, 2013 at 3:15 pm #62245
Ok, sorry, had the numbers mixed up. I would go to UCLA instead as they are doing a lot of the current research and have an excellent derm/researcher/Roger Lo: . Look forward to your call. http://www.derm.med.ucla.edu/?pg=physician_detail&pgid=2&phid=9&rid=2&parid=0
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