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Precancerous mole removal – need to understand the pathology report
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Precancerous mole removal – need to understand the pathology report

› Forums › Cutaneous Melanoma Community › Precancerous mole removal – need to understand the pathology report

  • Post
    • April 1, 2018 at 10:21 pm
    aliw121212
    Participant

      I had two moles removed last November.  The doctor first looked at them and didn't even think they were moles.  They were on my back in a place I couldn't see then (in bra strap area) but because I said my husband noticed them and thought they were new she removed them (saying I really don't expect them to be anything).  So I was surprised when I got a call back saying one was precancerous and needed to go back for a further shave as she hadn't got it all the first time. I asked what time it would have been had it progressed and she said melanoma.

      My first question is – four months on the scar is itching terribly and appears raised all the time.  Is this normal?

      Secondly my GP who is always a bit of a skeptic said well what is precancerous anyway, it is only cell changes it wasn't cancer.  So now I am confused and wondered if anyone could read what I see on the pathology report and let me know if it was a serious one (I see nothing that grades it) if I am at risk going forward and need to take extra precautions (I live in the south east where we have long got summers) or whether I should continue as normal.  Also does the very last statement mean there was something wrong with mole B too?  The doctor didn't give me much confidence because when I went back she numbed me up and got the scalpel out and then asked me "which one was it?".  I thought your the doctor lady – I hope you know what you are doing!

      A – dysplastic melanocytic nevus, junctional type

      B – seborrheic keratosis, pigmented

      Comment:

      A – a lateral edge is positive for neoplasm.  Conservative excision is suggested in order to perform additional histologic analysis and to ensure this proliferation has been removed from the patient.

      Clinical History – 2 dark moles R/O atypia

      Gross Description

      A – received in formalin is a shave biopsy of skin measuring 0.5 x 0.4 bisected and entirely submitted

      B – received in formalin is a shave biopsy of skin measuing 0.6 x 0.6, bisected and entirely submitted

      Microscopic description:

      A – a junctional type melanocytic nevus is present demonstrating architectural disorder and some cytologic atypia

      Based on initial morphologic findings and clinical history, stains were evaluated in order to establish teh diagnosis

      MART – 1: positive in lesional cells

      B – there is a basal and squamous proliferation within the epidermis with deposits of melanin associated with the basal areas. 

       

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        • April 1, 2018 at 10:46 pm
        aliw121212
        Participant

          Probably completely irrelevant but I had a cancer gene test done recently also that said I had BRIP1 – which doesn't have enough research right now to know whether it poses any kind of risks.

           

          • April 2, 2018 at 12:47 am
          Janner
          Participant

            Precancerous is not the right word.  The implies if left alone, it would become cancerous.  For the vast majority of atypical moles – they NEVER change into melanoma.  However, having atypical moles increases your risk for melanoma — higher than those who don't have atypical moles.  Certainly no surety of ever getting it.  However, your statement "continue as normal" should include sun safety measures to prevent ALL skin cancers.

            As for your reports, my guess is mildly to moderately atypical and getting clean margins is the typical treatment.  You've done that.  Itching? It can heal for a LONG time. The raised bit could be a keloid or just normal scar tissue that is healing.   Personally, I'm not a fan of shaves because I think they are more bothersome healing than any other biopsy type.  They also have the possibility of compromising staging of a melanoma if they bisect the mole and it turns out to be melanoma.  Lesion B is not a mole at all but a "SK" – totally benign lesion.  Common – as I get older, I keep getting more that seem to show up faster and faster.  They often grow back when removed.  As for the comment on B, that is just justifying the diagnosis and is not of concern.

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