Just diaganosed with a 7mm Melanoma

[Cort]

History-Melanoma killed my brother 21 years ago-mu sister has had two removed in early stages.

I have had good screening for years and yesterday was diaganosed with a 7 millimeter non pigmented melanoma on my back shoulder.

I live in the boonies near Eureka Cal. I am wondering if good local surgeon will be as good as driving to SanFrancisco’s UCSF Melanoma center as far as removal. I think lymph testing will occur as well.

My local Dermo wants it both done very soon locally. The UCSF clinic may take a few weeks to schedule. Any feeling on whats best-stay local and its done in a few days or travel (which I have no issues with) and get it done by experts in the field but will take longer.

Mark

[7spider]

I think for the most part they recomend going to have it done at a place that specializes in this. What is the thickness of the melanoma ? Looks like the 7mm is how long it is. The thickness will give you an idea of whether or not the do the lymph nodes test. Catherine and some of the other well informed people on here will help ya with any questions or concerns. Try not to freak out, there’s a lot of us in this club. We’ll help ya get thru it.

[Worrywart]

Wow, that doesn’t look like a melanoma. Do you have a copy of you path report? What was the history of the lesion – was it fast growing? Was it amelanotic or desmoplastic? Was it ulcerated or had you jsut picked at it? I agree that 7mm looks like the size, not depth. Depth is most important. Get a copy of your path report and that will explain a lot, and give you an idea of what you are looking at in terms of treatment possibilities.

[Cort]

I have acopy of the path report. The issue is the demotoligist did not think this was a melanome and did a shave tissue so the depth is not known yet.

The only hint is in the report-

Deep Margin:Involved

Tumor infiltrating lymphocytes: Brisk

Clark’s level 3

Diagnois: superfical spreading malignant melanomo at least level 3 measuring at least 0.6mm in depth,not excised

As of yet the staging number is an unknown-I have a consult with our local surgeon tomorrow.

They plan on a lymp node testing at same time of removal.

Mark

[Worrywart]

I am sorry that they did a shave. In future – no shaves! Hopefully the depth remains close to .6. How long had it been there? Prayers for a stage I lesion!

[Ellis2ca]

Cort wrote:

I have acopy of the path report. The issue is the demotoligist did not think this was a melanome and did a shave tissue so the depth is not known yet.

The only hint is in the report-

Deep Margin:Involved

Tumor infiltrating lymphocytes: Brisk

Clark’s level 3

Diagnois: superfical spreading malignant melanomo at least level 3 measuring at least 0.6mm in depth,not excised

As of yet the staging number is an unknown-I have a consult with our local surgeon tomorrow.

They plan on a lymp node testing at same time of removal.

Mark

Everybody seems to be from “the boonies” as you said, including the dermatologist and maybe also the pathologist.

The dermatologist should not have shaved it rather than complete excision… so, he did not think it was a melanoma… that is no excuse for shaving it instead of complete excision.

I can’t believe I am not a doctor, and I can figure this out myself but a doctor who is a specialist has not.

And this report “Tumor infiltrating lymphocytes: Brisk” is very curious…

What does “Brisk” mean?

I think “Tumor infiltrating lymphocytes” refers to the rate of mitosis, but that should be a number, for example “2” or “3” or “4” or “5” etc. per square millimeter.

Which one is “brisk”?

“Brisk”??? What does it MEAN? “a lot” “plenty fast” “mucho mucho”?

Why not “allegro con brio”… or “pianissimo”?

Is this a new nomenclature that he is using?

But in any case, it doesn’t look to me (I am not a doctor) like it is very advanced, so I will guess that it will not be very deep. What is left of it doesn’t even look like a melanoma to me… it seems like the remains of a basal cell carcinoma… but in any case, whatever it is, it looks like it is curable.

Of course, get it excised completely. You might also want a plastic surgeon to be there when it is time to sew you up, to avoid a bad scar… but it is on your shoulder… so no big deal…

Good luck to you. By the looks of the photo, my bet is that you got it on time because you are alert to watch out for melanomas… By the color (the worst I have seen are thick, and dark black), and size (7mm in diameter is not a very big melanoma) and in spite of my next-to-nothing experience, I think the depth was less than 1 mm and you will come out completely cured…

But it was truly “a close shave…” in more ways than one.

[Worrywart]

Brisk describes the TILS…it means the immune system was doing a good job of attacking the lesion. TILs are characterized as either brisk, non brisk or absent. This is not related to mitotic rate.

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