› Forums › Cutaneous Melanoma Community › Clark’s Nevus Pathology Report
- This topic has 5 replies, 4 voices, and was last updated 8 years, 5 months ago by
Janner.
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- April 14, 2017 at 12:58 am
After having two biopsies show melanoma insitu in January, I had 3 more biopsies done. Two of these sites were new moles (less than a couple years old ) and one was many years old but had changed over the past few years. It is the newness and the changes that deemed these sites worthy of biopsy.
The pathoodgy report reads: Clark's Nevus, Compound Type ( so-called Dysplastic Nevus). This is for all 3 of the biopsies.
For one of the sites, the report says "this lesion extends to the lateral msrgin."
I have two questions I hoping someone might be able to answer.
1) why wasn't the degree of dyslasia identiifed? Does the absence of comment mean it is not severe?
2) my surgeon wants to take more area from the one that didn't have clear margins. Am I unwise to put that off a few monthsl? I have to return to the dermatologist in late July and I bet she will want additional biopsies, I would rather get this larger margin problem taken care of when those additional biopsies are done in Aug or Sept. The surgeon didn't seem to like that idea, but I am wondering if he is being overly cautious or am I being cavalier? It just seems that with a dysplastic nevi there is no cancer so is another 4 or 5 months of much significance?
Appreciate your insight.
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- April 14, 2017 at 3:24 pm
Depending on your insurance, the doctor might get paid less for doing a surgery on the same day as the biopsies. That might be the only reason. It's worth asking the question.
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- April 15, 2017 at 12:57 am
Although Susan has a valid point and you should always ask those kinds of questions, there may possibly be another reason that your surgeon does not want to wait. My husband Roy had a red raised bumpy patch of skin on the right side of his face that I first noticed in 2014. Our family physician brushed it off and did not biopsy. In 2015 I insisted on a biopsy. Nevoid malignant melanoma send tumors down into the skin rather than spreading across the skin and is often undiagnosed until it is very advanced because it doesn't look like traditional melanoma. It took 3 weeks to get the results back because the samples were sent to 3 different labs. Each lab had a different opinion. 1 said the results were "inclusive", one suggested Dysplastic Nevus, and the final one concluded that it was nevoid malignant melanoma. I totally understand the appeal in waiting, but although my husband's really looked nothing on the surface it turned out to be 5mm deep with multiple nodules. The surgery to remove it (wide excision) and to create a skin flap took 5 hours. Had we waited, he may have been too far gone to be helped. That was 2 years ago. Although it is now back and metastasized, Stage IV, and he is being treated with Opdivo and Yervoy (with promising results thus far), we had 18 months NED (no evidence of disease) thanks to moving quickly and having wonderful surgeons and oncologists and dermatologists. You may regret having waited. You will probably never regret being too careful.
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- April 15, 2017 at 1:46 pm
Alison makes a very good point. I'm a big believer in "get it gone" sooner than later. I had just been looking at one of my husband's insurance statements and saw how they reduced a payment for multiple surgeries in one day when I hurredly responded! Health first … insurance and paperwork second!
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- April 15, 2017 at 10:36 pm
Thank you Alison and Susan for the reminder that i am wiser to be safe than sorry. I am getting tired of the slicing up process and having had so many dyplastic nevi all my life that no doctor ever made much fuss about, this just feels like an over reaction. But I will proceed in spite of that.
The information I have been reading seems contradictory and therefore confusing to me, on the one hand i read that skin cancer can errupt anywhere on your skin, so therefore there is no point in removing all our moles. But on the other hand, I read that dysplastic nevi can progress to MM, so then if a person is covered in many DN, doesn't it make sense to get them all removed in one swoop?
I am in Canada so there is no health insurance motivation on behalf of my surgoen, in fact, he could use my operating room time slot to do cosmetic work for higher compensation than my government insurance covered procedure would net him.
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Tagged: cutaneous melanoma
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