Hi all,
I was diagnosed with MIS in April last year. I had a WLE and continue to be monitored. There have been a few additional biopsies of suspicious moles along the way but none have been melanoma.
I recently moved from Ontario to BC and have been looking for a new Derm. Of course in the weeks I was trying to find a derm I noticed something a bit different in my WLE scar, there appears to be a small lump or at least a raised area within the scar. The scar is on my back and has been eveolving with time anyway (stretching, fading, evening out) and my derm in Ontario always said it was fine. I've got an oppointment with a derm this week and I plan to insist on a biopsy.
This has got me thinking about my pathology report and the likelyhood of recurrance in MIS. I was hoping to get some help interpreting the pathology report; my concern is that the derm will dismiss my concern because it was just MIS. Obviously it'd be fantastic if it is totaly benign but if there is a chance it isn't, I want to take action now.
Pathology (WLE pathology showed 5mm clear margins)
MICROSCOPIC: This biopsy is bisected. There is elongation of the rete ridges. There is prominent proliferation of nests and single atypical melanocytes along the dermo-epidermal junction. The cells are epithelioid and large. There is nucleoli. As well there is upward migration of single melanocytes noted in focal areas. The papillary dermis shows prominent fibroplasia, dense infiltrate of lymphocytes and melanophages and there are few nests of nevus cells. There is also one focal area at the edge of the biopsy showing fibrosis and increased number of vessels so there are changes suggestive of regression. The appearance is compatible with melanoma in situ developing in a dysplastic nevus. In the plane of section examined the melanocytes are extending very close to one lateral margin of the biopsy so the lesion is not completely excised. DIAGNOSIS: MELANOMA IN SITU IN A DYSPLASTIC NEVUS – NOT EXCISED
Any help would be appreciated.
Thanks,
D
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