› Forums › General Melanoma Community › 3 different results and Congenital Nevus
- This topic has 9 replies, 3 voices, and was last updated 10 years, 2 months ago by
Kacey79.
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- April 24, 2015 at 3:39 pm
Hi! New to the board and had a crazy ride so far. A mole I have had since birth, had a melanoma arise within it. Has anyone had this before? My first bioposy came back as: Clarks level III-IV with a lesion with app depth of 1.5mm, superficial spreading., but also said features that might suggest its arising from a congenital nevus, and should be considered approx. This triggered my surgeon to warrent a 2nd bioposy by someone that specialize more in melanoma. The 2nd report came back OPPOSITE! showing: Malignant Melanoma, superficial spreading, probable anatomic level 1 in-situ. WOW so now what do we do? I saw an oncologist who suggested I either do full surgery (SLNB and excision) or send it again to Dr. Mihms who deals with complex cases. I just got the new results today. It does explain it a bit more and I wonder if anyone has been in the same situtation? Malignant Melanoma, superficial spreaking, level IV, and a measured thickness of .55mm, arising with a compound congenital nevus with moderate atypia extending to within 1.5mm of the lateral margin. no ulceration, regression, or vascular invasion. Recommended a re-excision and the question of SNLB is left to the patient and physician. I haven't talked to the oncologist yet, no one calls back and I leave so many message (frustrating). And on another note I was scheduled for surgery today (because the oncologist said the 3rd results would be back mid week and as of last night at 5pm the nurses couldnt find them). So now my surgery will be this coming week and I am left to decide the best treatment. Any thoughts from the community? Also, with the full surgery, what is recovery like?
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- April 24, 2015 at 5:09 pm
I don't know stage 1 stuff but if I've read stuff right janner has posted then if there is a suspicion of melanoma at stage 1 then get it cut out with clear margins. Not sure if I got all that right but I'm pretty sure. Now what type of cutting out or what to expect I dunno. I know at stage 4 the zelboraf med caused a Squamish cell they cut out of my neck. They didn't get clear margins so I had them cut it again.
Artie
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- April 24, 2015 at 5:09 pm
I don't know stage 1 stuff but if I've read stuff right janner has posted then if there is a suspicion of melanoma at stage 1 then get it cut out with clear margins. Not sure if I got all that right but I'm pretty sure. Now what type of cutting out or what to expect I dunno. I know at stage 4 the zelboraf med caused a Squamish cell they cut out of my neck. They didn't get clear margins so I had them cut it again.
Artie
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- April 24, 2015 at 5:09 pm
I don't know stage 1 stuff but if I've read stuff right janner has posted then if there is a suspicion of melanoma at stage 1 then get it cut out with clear margins. Not sure if I got all that right but I'm pretty sure. Now what type of cutting out or what to expect I dunno. I know at stage 4 the zelboraf med caused a Squamish cell they cut out of my neck. They didn't get clear margins so I had them cut it again.
Artie
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- April 24, 2015 at 7:57 pm
The WLE is a large excision and wouldn't really change with any of the diagnoses. You have 1cm margins taken all the way around. The only question is whether or not you'd have the SNB. You don't list if there were any mitosis listed on any of the reports. Normally, 0.55mm wouldn't have the SNB unless you have other factors. The SNB is surgery and can have side effects. Usually it is pretty simple but it can cause lymphedema and there are the typical surgical infection and anesthesia risks. The WLE itself can usually be done under local, but add in the SNB and it will be general. Congenital nevi do have a higher risk of becoming melanoma, and it's really not uncommon to get 3 separate opinions when you talk to 3 pathologists – it's an art as much as a science. Talk with your oncologist, but this comes down to what makes YOU comfortable, not anyone else!
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- April 24, 2015 at 7:57 pm
The WLE is a large excision and wouldn't really change with any of the diagnoses. You have 1cm margins taken all the way around. The only question is whether or not you'd have the SNB. You don't list if there were any mitosis listed on any of the reports. Normally, 0.55mm wouldn't have the SNB unless you have other factors. The SNB is surgery and can have side effects. Usually it is pretty simple but it can cause lymphedema and there are the typical surgical infection and anesthesia risks. The WLE itself can usually be done under local, but add in the SNB and it will be general. Congenital nevi do have a higher risk of becoming melanoma, and it's really not uncommon to get 3 separate opinions when you talk to 3 pathologists – it's an art as much as a science. Talk with your oncologist, but this comes down to what makes YOU comfortable, not anyone else!
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- April 24, 2015 at 7:57 pm
The WLE is a large excision and wouldn't really change with any of the diagnoses. You have 1cm margins taken all the way around. The only question is whether or not you'd have the SNB. You don't list if there were any mitosis listed on any of the reports. Normally, 0.55mm wouldn't have the SNB unless you have other factors. The SNB is surgery and can have side effects. Usually it is pretty simple but it can cause lymphedema and there are the typical surgical infection and anesthesia risks. The WLE itself can usually be done under local, but add in the SNB and it will be general. Congenital nevi do have a higher risk of becoming melanoma, and it's really not uncommon to get 3 separate opinions when you talk to 3 pathologists – it's an art as much as a science. Talk with your oncologist, but this comes down to what makes YOU comfortable, not anyone else!
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- April 24, 2015 at 9:46 pm
Hi Jessann,
This is similiar to my diagnosis last year. My melanoma developed in a mole I've had for as long as I can remember. The pathology with my dermatologist's office showed the initial diagnosis as a 1.3 mm breslow depth, clarks level III, and <1 mitiotic rate.
With the depth being reported over 1 mm, I was to have a SLNB and WLE surgery. I live in Florida and my dermatologist highly suggested I go to Moffitt Cancer Center in Tampa since they're well known for their expertise. The staff at Moffitt reviewed my slides and downgraded my melanoma from 1.3 mm to .3 mm. The originally pathology apparently included some of my mole "nevus" in with the depth.
Moffitt only did a WLE and no SNLB since it was less than 1 mm. It's been about a year and I've had no more incidences with that area. My dermatologist did get a 3rd opinion just to be on the safe side and the 3rd opinion actually showed it as in-situ.
I hope this helps. It is an overwhelming time, I know. Feel free to look me up on facebook:
kacey mingus
Good luck
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- April 24, 2015 at 9:46 pm
Hi Jessann,
This is similiar to my diagnosis last year. My melanoma developed in a mole I've had for as long as I can remember. The pathology with my dermatologist's office showed the initial diagnosis as a 1.3 mm breslow depth, clarks level III, and <1 mitiotic rate.
With the depth being reported over 1 mm, I was to have a SLNB and WLE surgery. I live in Florida and my dermatologist highly suggested I go to Moffitt Cancer Center in Tampa since they're well known for their expertise. The staff at Moffitt reviewed my slides and downgraded my melanoma from 1.3 mm to .3 mm. The originally pathology apparently included some of my mole "nevus" in with the depth.
Moffitt only did a WLE and no SNLB since it was less than 1 mm. It's been about a year and I've had no more incidences with that area. My dermatologist did get a 3rd opinion just to be on the safe side and the 3rd opinion actually showed it as in-situ.
I hope this helps. It is an overwhelming time, I know. Feel free to look me up on facebook:
kacey mingus
Good luck
-
- April 24, 2015 at 9:46 pm
Hi Jessann,
This is similiar to my diagnosis last year. My melanoma developed in a mole I've had for as long as I can remember. The pathology with my dermatologist's office showed the initial diagnosis as a 1.3 mm breslow depth, clarks level III, and <1 mitiotic rate.
With the depth being reported over 1 mm, I was to have a SLNB and WLE surgery. I live in Florida and my dermatologist highly suggested I go to Moffitt Cancer Center in Tampa since they're well known for their expertise. The staff at Moffitt reviewed my slides and downgraded my melanoma from 1.3 mm to .3 mm. The originally pathology apparently included some of my mole "nevus" in with the depth.
Moffitt only did a WLE and no SNLB since it was less than 1 mm. It's been about a year and I've had no more incidences with that area. My dermatologist did get a 3rd opinion just to be on the safe side and the 3rd opinion actually showed it as in-situ.
I hope this helps. It is an overwhelming time, I know. Feel free to look me up on facebook:
kacey mingus
Good luck
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Tagged: cutaneous melanoma
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