Home Forums Melanoma: Stage III positive SLN and in-transit met

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    My father was diagnosed with nodular melanoma beginning of May. It was located just under his right nipple. Breslow 1.43 mm, Clark IV, ulceration present, mitotic rate 15/mm2 (!!).

    He is Swiss but lives in Brazil and decided to come to Switzerland for further exams. He had an appointment with the der, the onco and the surgeon altogether in a melanoma clinic on 05/22. They checked his skin and felt his lymph nodes and said there was nothing particular. He also had a ct-scan.

    He had a SLN and WLE on the 6/14 and got the results 2 weeks later. Two nodes were taken out and one was positive. It was 1cm enlarged and the capsule was broken with melanoma cells in the surrounded fat tissue. There was also one subcutaneous in-transit met in the tissue removed with the WLE. The pathology report and the surgeon said it was a satellite but one of the derm talked about in-transit met. Is it right that the difference is in the distance from the primary melanoma and that it doesn’t make a lot of difference for prognosis? With the in-transit met and at least 1 lymph node positive, is he already stage IIIc?

    He had complete lymph node dissection under his right arm on 07/17 and is now trying to get used to the drain. Before the node dissection he also had brain MRI. The appointment with the surgeon to get the results is on the 07/30.

    I know there is not much we can do before he has a definitive staging. As I am a biologist and work in the medical field, I feel the need to understand every step of the process and read about options but this also makes me jump to conclusions and worry. It is just so frustrating that he’s been diagnosed 2 months ago and we still don’t know what is going to happen in terms of treatment.

    My father hopes it will be a watch and wait option so that he and my mother could go back home to Brazil. Do any of you know about any melanoma specialist and treatment options in Brazil?

    Thanks for reading my post and for your support.


    Catherine Poole

    I’m a little confused about the satellite vs. intransit met. I’m pretty certain they would be considered the same in the prognosis of things. At this point the only therapy your father might be able to get in Brazil is Yervoy as adjuvant therapy. And yet, his staging may preclude this. Otherwise, watch and wait is the best the thing we have going. There are some others in the wings that I will double check on, but doubt they would be available in Brazil, but possibly in Switzerland. I will let you know. Your father is fortunate to have you looking out for him.


    Catherine, thank you for your reply and your help. Life has changed since my father was diagnosed but I still don’t know to what extent. The unknown is quite unsettling and frightening.

    This forum has been very helpful. The stories and experiences shared here are very inspiring. Thank you.

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