New satiliite mole following wide local excision with rotational graft.

I have come to this site countless times of the last 6 months and always came away having learned something. While I have never posted, I know I can usually find answers. I am having a tough time this go around though. I’ll give as brief of a history as I can. Red hair/fair skin/freckles/grew up with a swimming pool and blistering sunburns.

10/2010 – New mole appeared and grew quickly on my right nostril. Shave biopsy was a-typical but they wanted to do MOHs since it was so a-typical. I basically had all the skin on my nostril removed with a skin graft from behind my ear.
11/2011 – Several new moles showed up around the grafted area. A shave biopsy was done. Again, severely A-typical but no diagnosis. Path report did mention positive HMB45 but “further re-excision would result in significant disfigurement”. I was told to watch them. I did not
know what HMB45 was and trusted my Doc.
10/2012 – I watched one of the now known satilittes grow to the size of a pencil eraser. I switched dermatologists. Upon my arrival she immediately referred me to a top MOHs surgeon here in Houston saying it was definatly not normal and immediate action needed to be taken. Upon seeing me the MOHs surgeon said he would not preform MOHs. (He usually does them at the first visit) He did a biopsy. 4 days later they called and I missed the call. When I called back I was informed the dr was out the rest of the week but they would call Monday. 1/2 hour later the dr. Called me from his car. “Invasive malignant nodular melanoma, deep vertical margins positive with ulceration, at least >3mm, at least clarks level IV and satilitte lesions.” Followed by he was very sorry to have to tell me.

Many scans and appointments at MD Anderson later. “We can’t read the future, but we’re shooting for a cure.” My favorite quote from my head/neck doc.

1/7/2013 – wide local excision, graft delayed for clean margins report. 4 Syntinel nodes removed for biopsy but due to the cancer being in the head/neck I “lite up like a Christmas tree” during mapping making deciding which nodes to remove difficult.
1/10/2013 – wider margins taken due to unclean margins during the wide local excision. followed by rotational graft to cover the wound. 102 staples from my right ear, along my sunglasses line, around half my nose, down to my lip.
1/14/2013 – node pathology report: 1 of 4 nodes postitive for mestestic melanoma. Micro, subcapsular and capsular, no extracaoular. My surgeon mentioned lymph node removal but did not believe it “would benefit me at this time”.
2/17/2013 – face and neck high dose radiation. Healing poorly with skin still dying 3 months later. Interpheron not an option due to my severe SLE (lupus)
4/7/13 – new mole just outside of wide excision scar. Appeared like previous satilittes. Head/neck surgeon wanted to wait for biopsy due to radiation damaged skin. New CT scan was clean.
6/7/2013 – MD Anderson dermatologist told me it would have to be removed if I wanted to continue treatment and “its aggressive”. I’m not sure how to take that.

The last 8 months have been a wild and crazy ride.

I have been told everything from IIIA to IIIC depending on which doctor I saw at what point during treatment.

I wanted to see if anyone has experience with recurring satilittes just a few months following clean wide margins. Any insight would be greatly appreciated. I’ve been very positive throughout the past 8 months. I’ve learned to make light of the situation as a defense but its getting harder. I don’t feel like my docs are being honest with me anymore.