› Forums › General Melanoma Community › Help me interpret this pathology report
- This topic has 9 replies, 2 voices, and was last updated 8 years, 11 months ago by
Janner.
- Post
-
- October 12, 2016 at 12:40 pm
Hi, I have just had a (quoting my family doctor) "scary looking thing" of a mole cut from my left labia majora. I understand this is a forum for melanoma patients and I have not been diagnosed with melanoma yet so I hope this is not inappropriate to post but I figure that you may be able to help me interpret what my doctor has told me so far.
first of all, im 18years old (female obviously) and suffer some anxiety/panic attacks so this is experience has been quite uncomfortable. I have had this mole on my left Labia majora since as long as I can remember – possibly since birth. I first brought it to the attention of my mum I think when I was around 8 years old. Naturally, she thought we should get it looked at asap so took me to one of those medical centres because you get in straight away no appointment needed (a bit like supermarket medicine I have come to think). I distinctly remember the doctor (who was a young girl probably not older than 28 or so) saying it was a blood blister that would probably go away. Even at 8 years old I think I knew it wasn't but didn't give it much more thought till my teens. Because of the awkwardness of its location I didn't bring it up with anyone again, until 2 or so months ago when I noticed it has POSSSIBLY gotten the slightest bit bigger. I decided to make an appointment with my doctor to get it out, which to be honest was mostly because I thought it was embarrassing to have (and I had not at all considered melanoma nor knew anything much about it). knowing I wanted it to be taken seriously enough that he would remove it, I told the doctor it has definitely gotten a little bigger (this is the first time he's known about it). He took a punch biopsy, two stitches later, sent off the piece and the pathology test came back benign though I didn't read the exact report. after u had the two stitches out I went back and he told me I could either leave it or remove it, but that the nature of the mole was between the two layers, the epidermis and the dermis (or somewhat within both I'm not sure of his exact words) and that it would grow wider. I think he said something about that aesthetically I would want it removed (and I already do so said go ahead and take it out). He took a biggish chunk and gave me six stitches, and sent that off for another pathology test. I went back yesterday to get the stitches out and the conversation went as follows:
"I've got good news and bad news for you, good news is that I got it all out, bad news is they want a second opinion on the pathology test". I asked him what would happen if it came back as melanoma and he said "oh well we'll deal with that when we come to it". This freaked me out but I kept my cool until I got home and actually read the pathology report, which he gave me this time.
This is what it says exactly:
"clinical notes: left labia lesion, suture marks lateral end of leaion. Wider excision of s16/150481.
Macroscopic examination: the specimen consists of an ellipse of skin 18x8x5mm beating a brown macular 9x7mm. A sature is present at one poor designated as 12oclock.
Microsopic examination: the sections of the previous biopsy were reviewed and the findings confirmed. This re-excision specimen shows central dermal scarring and mild inflammation in keeping with The previous biopsy. There is an overlying mild increase in junctional melanocytic activity throughout, with minimal atypia. there is no pagetoid epidermal spread or any other features of malignancy. These changes come within 1.0 mm of each radial margin.
The possibility of an atypical vulver naevus was considered but the changes appear reactive and Insufficient for this diagnosis. However, in view of the patients age and if the site of the lesion, further opinion from RPAT [this is my country's major/best hospital / melanoma clinic I have sinced researched and realised] would be advisable.
The sections have also been examined by other pathologists in the group, who agree with these findings."
ok so, I have two major concerns with this.
1. The mole being 9×7 mm which is beyond the 6mm margin designated for the ABCDE rule (given the nature of the skin at the site it definitely did not appear this big to me so this is a bit of a shock)
2. Now this is the major one playing on my mind. If my doctor did in fact "get it all out" (his words, not the pathologists as far as I can tell in the report?) then what is the purpose of the second opinion they are advising??? Since, from what I gather, they seem to think the mole is ok, I'm GUESSING if they were incorrect, it couldn't be worse than stage 1 .. Or am I wrong to assume that they couldn't completely stuff up and that it potentially could be worse than stage 1 ?? (Please note what my doctor originally said about the layers epidermis and dermis).. Ok so IF it is pre cancerous or cancerous and they discover that in the second option at the major hospital pathology clinic, then what does that mean for me ? If it is truly all out what exactly is the purpose of the second opionion? Could this imply that it may have spread beyond the site to lymph nodes if it was intact not a benign mole, hence the need for the second opionion?
Or, as my mum is trying to convince me, is the second opion merely to confirm that it is being , because if it wasn't they would merely like to have on my medical record that I had a pre cancerous or cancerous mole removed and basically warn me to keep an eye out for other body moles… I will also note, as my mum thinks, my family doctor is the type to 'sensationalise' things..
I might also mention that I will be waiting 2-3 weeks for the results of this second opionion, and that over these 2-3 weeks I have some very important high school exams, and all I can think about is that damn second opinion and what that actually means.
Thank you so much for any information/ interpretation you might have.
- Replies
-
-
- October 12, 2016 at 12:43 pm
Sorry for spelling mistakes in writing on this my iPhone keypad 11.30pm. I meant second opinion* not second option, and infact** not intact
-
- October 12, 2016 at 1:02 pm
Upon re reading that word-vomit like story I thought I should just clear up what my main question is:
in light of the fact that the pathologists at my local pathology clinic seem to (I think..) have come to the consensus that the mole is/was ok,
Is it possible that the diagnosis could progress from
A) we think the mole is benign but want to double check with a second opion
to
B) the mole is not fine, but in fact is malignant, and may have spread beyond the site Despite now having been removed (hence, lymph node check?)
or is more likely that the second opionion is for the purpose of medical records/ making me aware of other potential moles …
-
- October 12, 2016 at 2:12 pm
Second opinion is just that, a second opinion. Not uncommon for any lesion but given your age and location, I say they are just being cautious. The atypia is listed as mild and that is a very far stretch from malignant. I, personally, would not be worrying that this is malignant despite getting a second opinion. You want to have it read by someone who reads lots of skin lesions daily. A second opinion is really a good thing and I wouldn't spend any time worrying that the diagnosis will change significantly.
-
- October 12, 2016 at 2:12 pm
Second opinion is just that, a second opinion. Not uncommon for any lesion but given your age and location, I say they are just being cautious. The atypia is listed as mild and that is a very far stretch from malignant. I, personally, would not be worrying that this is malignant despite getting a second opinion. You want to have it read by someone who reads lots of skin lesions daily. A second opinion is really a good thing and I wouldn't spend any time worrying that the diagnosis will change significantly.
-
- October 12, 2016 at 2:12 pm
Second opinion is just that, a second opinion. Not uncommon for any lesion but given your age and location, I say they are just being cautious. The atypia is listed as mild and that is a very far stretch from malignant. I, personally, would not be worrying that this is malignant despite getting a second opinion. You want to have it read by someone who reads lots of skin lesions daily. A second opinion is really a good thing and I wouldn't spend any time worrying that the diagnosis will change significantly.
-
- October 12, 2016 at 1:02 pm
Upon re reading that word-vomit like story I thought I should just clear up what my main question is:
in light of the fact that the pathologists at my local pathology clinic seem to (I think..) have come to the consensus that the mole is/was ok,
Is it possible that the diagnosis could progress from
A) we think the mole is benign but want to double check with a second opion
to
B) the mole is not fine, but in fact is malignant, and may have spread beyond the site Despite now having been removed (hence, lymph node check?)
or is more likely that the second opionion is for the purpose of medical records/ making me aware of other potential moles …
-
- October 12, 2016 at 1:02 pm
Upon re reading that word-vomit like story I thought I should just clear up what my main question is:
in light of the fact that the pathologists at my local pathology clinic seem to (I think..) have come to the consensus that the mole is/was ok,
Is it possible that the diagnosis could progress from
A) we think the mole is benign but want to double check with a second opion
to
B) the mole is not fine, but in fact is malignant, and may have spread beyond the site Despite now having been removed (hence, lymph node check?)
or is more likely that the second opionion is for the purpose of medical records/ making me aware of other potential moles …
-
- October 12, 2016 at 12:43 pm
Sorry for spelling mistakes in writing on this my iPhone keypad 11.30pm. I meant second opinion* not second option, and infact** not intact
-
- October 12, 2016 at 12:43 pm
Sorry for spelling mistakes in writing on this my iPhone keypad 11.30pm. I meant second opinion* not second option, and infact** not intact
-
Tagged: cutaneous melanoma
- You must be logged in to reply to this topic.