Metastatic melanoma

In the most simplest terms, a melanoma primary grows from the top of the skin (epidermis) down toward the lymph and blood vessels deeper in the skin.  A metastatic lesion gets to a site from the lymph vessels (less likely bllood vessels).  So the melanoma starts at the base of the skin and grows from there.  Metastatic lesions don't usually have a component in the epidermis and have different growth patterns.   It is certainly feasible to have your pathology slides read by someone else if you want another opinion.

PET scans only show tumors of a certain size.  So it's great that you don't have any tumors showing that are larger than say 5mm.  PET scans just show metabolic activity.  So the biopsy trauma itself might be the cause for the PET scan showing the biopsy site.

I'd say no on skipping the melanoma specialist.  You need to have an expert opinion.  There are treatment options even if you show no other tumors – to hopefully keep things that way.  You want to establish a relationship with a doctor so if you have future issues, you are ready to go.  Skipping the specialist isn't a good move.  Just my opinion.

I would also not skip the specialist!  They have a deeper understanding of this disease and the best course of treatment for your regardless of stage.  When my journey began I was also very scared and very lost.  Luckily I had a great primary care who directed me to a great specialist at Dana Farber.  Try to keep breathing.  See your specialist and find your path.  I wish you the best.

Jennifer

I was diagnosed as having a metastatic melanoma in my upper arm and it was excised with wide margins. My PET-CT Scan was clean as was my brain MRI. So when it was recommended I do a year of Opdivo I went for a second opinion because I wanted to make sure it made sense to do a year of treatments when I had no evidence of tumors. My second opinion said it was the easiest he could do – a no brainer to have the treatments and decrease the chance of recurrence by 50%. I had my first treatment a week ago. I feel good. 25 to go.

I agree with the recommendations to see the specialist. Don't be afraid, be positive. All of the advice I am getting says keep your appointments for scans and treatments so you tilt everything in your favor.

Good luck!