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  • #21350
    bella1958
    Participant

    On the 1/2/2013 i was diagnosed with melanoma in situ on the right check Clark level stage 0, a wide local excision was performed and final pathogly report:

    Macroscope description

    Specimen: right check. An orientated oval skin 30x22x3mmwith a centrall ill-defined brown patch 18x15mm.

    Microscopic description

    Sections show sun damged skin in which there is a lentigo maligna(hutchinson s melanotic freckle). There is a lentiginous and partly nested proliferation of atypical melanocytes in atrophic epidermis, with adnexal extension. No invasive melanoma is identified. There is heavy upper dermal lymphoplasmacytic inflammation with some fibrosis consistent with superficial regression. The lesion is completely excised with a 6 mm minnum clearance to all peripheral cutaneous margins.

    Conclusion

    right cheek, excision

    Lentigo maligna melanoma in situ, with superficial regression, completely excised 6mm clearance.

    Can any one explain what all means?

    #61182
    Catherine Poole
    Keymaster

    This is all good news. Has your doctor explained your diagnosis. You have low risk melanoma and a type that tends to come back but still won’t be dangerous. In situ means “in place” which indicates it doesn’t have the capacity to metastasize.

    #61183
    Worrywart
    Participant

    Hi there,

    You have been dx with lentigo maligna, a slow growing melanoma in situ (in place, did not spread) that usually appears on sun damaged skin. It looks like they got good margins. Is the incision healing okay? Regression just means your body started to attack the lesion, but the regression was superficial so that won’t affect prognosis.

    #61184
    Delyse
    Participant

    Hi, I am a new member. I live in Australia. I have been diagnosed with several lentigo malignas on my face. The first diagnosis was in 2006. I had had a little mole plus some little spots around it for years and years on my left cheek. It never grew and I often wondered what the little bumps were (or spots) but that’s about all. In 2006, it started to grow. It became a little unsightly so I went to a surgeon who burnt it off. Two years later, it grew again, this time much bigger. Alarm bells went off and I found a good plastic surgeon and had it biopsied and subsequently excised. It was diagnosed as a lentigo maligna. This year, it started to grow once again and after a biopsy, I had a skin graft on the same site and I now have a rather unsightly large scar on my face which is slowly recovering and healing. I could deal with that. However, my plastic surgeon has told me it might grow yet again as it is so hard to tell where the boundaries are. When giving me the skin graft, I also pointed out to him another similar growth on my right cheek. He biopsied it and has declared it another lentigo maligna.

    This time I researched and found a specialist dermatologist who is in one of our leading hospitals who can image the lengito site and plot where the boundaries are. I was amazed that my plastic surgeon had not advocated this to me in the beginning. I went down earlier this year and had what they call Confocal Invivo Imaging done on the new site on my right cheek. She said it is early stages but is spread out. The report has gone to my plastic surgeon and he now says he will have to do another skin graft as he has to take a wide excision. I also found out when having the imaging done that I have sunspots on my forehead and lips which has to be burnt off by a dermatologist.

    My reasons for joining MIF are to try to find some support for the increasing feelings of alarm bells going off in my head. I can find nobody to discuss future treatment. I do not feel “in control” of the situation. They are finding lentigos, I am directed to have them excised and so it goes on. What I want to ask is where does it all stop? Where do I draw the line about having my face cut up? Am I destined to go through life from now on with scars all over it? The surgeon is too busy to sit and discuss it with me, the specialist dermatologist was in the same boat, so who do I talk to? I have also had breast cancer. The amount of support amongst health professionals is immense and made things so much easier for me. With melanomas, however, there is hardly any that I could find. I have stumbled upon this website and have my fingers crossed I can find others and discuss lentigos.

    I wondered if anybody felt the same as me? If so, I wonder what we can find out about it all and how we can take back control of our own bodies?

    Thank you for reading my post

    Del

    #61185
    Delyse
    Participant

    Bella, yes, good news for you. The site is completely excised and is clear. However, you will need to check the site often in case it grows again. It sounds very much like mine.

    I’m not sure of your age but I am in my early 70s now and when I was younger, all we thought was to get a good tan and almost live on the beach each weekend. We were completely unaware. Now, we are paying the price.

    My worry is how often do we have them excised with the resulting scars? If it was somewhere else than my face, I perhaps wouldn’t be so worried about it. The scars for an excision are not too bad but when it starts becoming a skin graft as well and more than one, I am wondering when we say no, let’s wait. Or, alternatively, can we not wait? The plastic surgeon doesn’t seem to think in those terms. Has anyone got a view on this? http://forum.melanomainternational.org/mif/posting.php?mode=reply&f=56&t=34330#

    #61186
    Catherine Poole
    Keymaster

    Topical chemotherapy cream seems to offer an alternative to preventing this from coming back, it is close to what they do when they do a chemical peel. I will check with our scientific board director who is a professor of dermatology to make sure this is still a current treatment that may help avoid surgery. Here’s an older study: http://www.ncbi.nlm.nih.gov/pubmed/1111940

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