Can anyone help me understand my report? My guess is that it is melanoma in-sit (so, on the top layer of the skin only? How often does it get upstaged after the Wide Local Re-excision? I’m so confused.
Punch Biopsy: Melanoma in Situ (face, cheek).
Wide local re-excision (5mm margin) scheduled next week.
– punch biopsy shows presence of an atypical junctional melanocytic lesion characterized by occasional nests of atypical melanocytes along the base of the epidermis with the long axis parallel to hte epidermal surface as well as single melanocytes with atypical cytological features extending into the upper portions of the epidermis as well as focally showing a confluent growth patter along the basal layer.
There is involvement of follicular epithelium. There are melanophages in the superficial dermis as well as mild perivascular chronic inflammation. There is absence of an intradermal melanocytic omponent in the punch biopsy. There is minimal dermal solar elastosis. The lesion extends to and is present in the peripheral borders of the punch biopsy. The specimen is 0.3cm x 0.3 cmx 0.3 cm in depth.
Yes, this is a very low risk lesion. If you are in Canada you may not have the option, but I would recommend plastic surgeon because it is in a cosmetically sensitive area. . In situ means the melanoma is very unlikely to spread. The rest of the jargon in the report is not significant for predicting any recurrence but is just a description of the sample. I hope this helps and you might check our section on pathology: http://melanomainternational.org/melanoma-facts/pathology/#.XC9XFVVKiM8