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I need help

› Forums › General Melanoma Community › I need help

  • Post
    • April 10, 2018 at 7:24 am
    abeluta
    Participant

      Hello. I am a 41-year-old woman from Romania and I apologize if I do not express myself correctly. In December 2017 we got the diagnosis of melanoma in situ completely excised with clean edges. For my silence I asked for the second opinion and the result came in three months (March 2018) totally different – Spitzoid type extensive melanoma in the surface Breslow 1.3mm Clark 3. The anatomopathologist who worked the first time does not explain why she the result came so that all the damage in depth was under 1 mm (she had seen 0.6 radial growth in the epidermis) and sent the lasers to 3 of the opinion that came with malignant melanoma Breslow 0.7 and Clark 3. I'm totally debuslated. I have 3 totally different results, if I analyze the results nothing coincides. neither the depth nor the mitosis or the rest of the details in the description. What do you advise me to do? Spitzoid melanoma how does it look? my lesion had an atypical appearance with irregular edges. I did CT with a contrast substance on 4 segments (head, thorax, abdomen and pelvis) and went out well, my lungs said I had two 0.5 mm nodules but were calcified and unrelated to melanoma and the echo soft parts in the inguinal region came out ok with ganglia in normal limits. I am scared, I do not know what to do, but I can help with advice. I'm thinking of sending biopsies to another country but I do not know where.

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        • April 10, 2018 at 4:05 pm
        Janner
        Participant

          Did you have a wide excision to remove extra tissue – not just clean margins? 

          The standard of care for all of these diagnoses is basically removing with 1 cm margins.  If you haven't already had the wide excision, you could request a sentinel lymph node biopsy given the one report stating over 1mm.  Only do that with a doc who does lots of SLNB because that matters.  But if you have already had extra margins taken, that test may not be accurate and it isn't worth doing.  You will never get an absolute answer.  Pathology is as much an art as a science and there will never be a complete agreement by pathologists.  Are any of the pathologists dedicated to skin only?  What you would really like to see is someone to look at this who diagnosis melanoma on a daily basis.   If you send to another pathologist, you will have a 4th opinion.  What does that really give you?  All of these diagnoses are stage 1 and all require 1 cm margins.  There isn't any additional treatment for any of them recommended.  So if the treatment is the same, the only thing you are gaining by another opinion is just that – another opinion.  Nothing else changes.

           

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