› Forums › General Melanoma Community › Possible Melanoma in Scar Site of Biopsy?
- This topic has 15 replies, 4 voices, and was last updated 8 years, 6 months ago by
cestlaviemle.
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- October 22, 2016 at 10:22 pm
Hello,
Thank you for taking the time to read my post.
In early June I went to a doctor for a follow up on a broken foot. While there, I asked if she would take a look at a mole on my lower back that felt like it was growing and seemed to be getting a bit irritated. She said she thought it was likely benign but because it fit all the ABCDEs and I have a family history of melanoma, she thought we should remove it. She performed a shave biopsy and it came back completely benign. I have posted the pathology report in case it's helpful at all.
CLINICAL HISTORY: Benign skin lesion/atypical nevus vs dysplastic nevus
FINAL DIAGNOSIS: A) Lower back
Melanocytic Nevus, Intradermal Type (D22.5)
Note: This nevus is irritated. Nevus extends to the deep margin of the
specimen but there is no evidence of malignancy.GROSS: A) 1cm x 8mm x 2mm, SHAVE, BISECTED, TOTALLY SUBMITTED
MICROSCOPIC: A) There are nests of typical nevus cells within the dermis.
There is focal parakeratosis.
At the beginning of October, I was establishing care with a new primary and getting a check up. She noted that I have a lot of moles on my back and then I pointed out the spot of the biopsy. Immediately she stated that it needed to come off. She could tell I was surprised and I made sure to tell her the report was completely normal. She checked my chart and agreed it sounded like nothing but reiterated if it was on her or one of her kids, she'd have it taken off with a punch biopsy this time.
I am conflicted here because the same day of that appointment, my husband was laid off and the cost of another biopsy seems like a lot right now. I'm not one to go against a doctor's recommendation, but from the little I have found on this topic it seems pretty unlikely that a) the first biopsy was wrong or b) something new that is cancerous or precancerous has grown in the scar in such a short period of time.
I couldn't figure out how to post a picture here, so I made my profile picture a pic of the current scar tissue with new pigmentation. It sounds like it's very normal for a scar from a shave biopsy to regrow a mole, I just can't find anything on if the specific way mine is coming back looks especially concerning.
I would so appreciate any thoughts or guidance!
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- October 23, 2016 at 2:35 pm
Tough call. Unlikely that the lesion is anything other than benign although a biopsy might show some atypia now. Anything read through scar tissue will look worse that it might really be. Scar tissue can change the look of melanocytes. (Pathologists typically understand this but it bears noting). Shave biopsies are notorious for leaving behind cells so in the future, I suggest another method of biopsy. As for your current lesion, I'd probably monitor it closely. If it really continues to evolve and change significantly, I'd pay for the biopsy. Alternately, I'd have the biopsy once you regain insurance just to get rid of it. My doc (melanoma specialist) does not like any pigment regrowth in lesions and most likely would also suggest removal. But since it was benign, I'd probably wait until I had insurance to take care of it unless continued changes really indicated something more was going on. You have to do what makes YOU comfortable, no one else. (I recently battled expensive health issues with no insurance and I get it! Some expensive things I had to do immediately but did put off other stuff until I had insurance. No easy answers).
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- October 23, 2016 at 2:35 pm
Tough call. Unlikely that the lesion is anything other than benign although a biopsy might show some atypia now. Anything read through scar tissue will look worse that it might really be. Scar tissue can change the look of melanocytes. (Pathologists typically understand this but it bears noting). Shave biopsies are notorious for leaving behind cells so in the future, I suggest another method of biopsy. As for your current lesion, I'd probably monitor it closely. If it really continues to evolve and change significantly, I'd pay for the biopsy. Alternately, I'd have the biopsy once you regain insurance just to get rid of it. My doc (melanoma specialist) does not like any pigment regrowth in lesions and most likely would also suggest removal. But since it was benign, I'd probably wait until I had insurance to take care of it unless continued changes really indicated something more was going on. You have to do what makes YOU comfortable, no one else. (I recently battled expensive health issues with no insurance and I get it! Some expensive things I had to do immediately but did put off other stuff until I had insurance. No easy answers).
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- October 23, 2016 at 11:12 pm
Janner this is completely unrelated but I noticed you see a melanoma specialist, are you referring to a dermatologist that is a melanoma specialist? I'm gathering as much info as possible as I can. Recently diagnosed. A surgical oncologist with some melanoma experience performed the surgery but I will be going for my follow up this week. I've read that melanoma specialist is a must if further treatment is needed after the wide excision but can melanoma specialist be seen if a monitoring process is the next step? Thank you!
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- October 23, 2016 at 11:12 pm
Janner this is completely unrelated but I noticed you see a melanoma specialist, are you referring to a dermatologist that is a melanoma specialist? I'm gathering as much info as possible as I can. Recently diagnosed. A surgical oncologist with some melanoma experience performed the surgery but I will be going for my follow up this week. I've read that melanoma specialist is a must if further treatment is needed after the wide excision but can melanoma specialist be seen if a monitoring process is the next step? Thank you!
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- October 24, 2016 at 1:06 am
They are tough to find, but I see a cutaneous oncologist. Basically a derm that specializes in skin cancer. He's a Mohs surgeon as well. I think he also sees cutaneous lymphoma patients. But no botox, acne or anything like that, only cancer.
This is not the same type of specialist you would look for if you were to need treatment. If you aren't stage III/IV, then a derm or cutaneous oncologist are most likely what you need. Most real melanoma specialists will not see early stage people – there is nothing to offer them. Most early stagers have a higher risk of another melanoma primary than a recurrence so a derm makes sense. A melanoma specialist makes real sense if you are stage III/IV for many reasons but not so much for early stagers.
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- October 24, 2016 at 1:06 am
They are tough to find, but I see a cutaneous oncologist. Basically a derm that specializes in skin cancer. He's a Mohs surgeon as well. I think he also sees cutaneous lymphoma patients. But no botox, acne or anything like that, only cancer.
This is not the same type of specialist you would look for if you were to need treatment. If you aren't stage III/IV, then a derm or cutaneous oncologist are most likely what you need. Most real melanoma specialists will not see early stage people – there is nothing to offer them. Most early stagers have a higher risk of another melanoma primary than a recurrence so a derm makes sense. A melanoma specialist makes real sense if you are stage III/IV for many reasons but not so much for early stagers.
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- October 24, 2016 at 1:06 am
They are tough to find, but I see a cutaneous oncologist. Basically a derm that specializes in skin cancer. He's a Mohs surgeon as well. I think he also sees cutaneous lymphoma patients. But no botox, acne or anything like that, only cancer.
This is not the same type of specialist you would look for if you were to need treatment. If you aren't stage III/IV, then a derm or cutaneous oncologist are most likely what you need. Most real melanoma specialists will not see early stage people – there is nothing to offer them. Most early stagers have a higher risk of another melanoma primary than a recurrence so a derm makes sense. A melanoma specialist makes real sense if you are stage III/IV for many reasons but not so much for early stagers.
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- October 23, 2016 at 11:12 pm
Janner this is completely unrelated but I noticed you see a melanoma specialist, are you referring to a dermatologist that is a melanoma specialist? I'm gathering as much info as possible as I can. Recently diagnosed. A surgical oncologist with some melanoma experience performed the surgery but I will be going for my follow up this week. I've read that melanoma specialist is a must if further treatment is needed after the wide excision but can melanoma specialist be seen if a monitoring process is the next step? Thank you!
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- October 26, 2016 at 1:21 am
Thank you so much for the replies, I genuinely appreciate it. I think it makes sense to monitor it for now and get the biopsy when we've got insurance again or there is further change. I know everyone here has much bigger things going on and I value that you offered some insight into this uncertainty of mine. Since my mother's melanoma, I've tried my best to be prudent when taking care of my skin, but it can be hard to know when the biopsies are the right call.
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- October 26, 2016 at 1:21 am
Thank you so much for the replies, I genuinely appreciate it. I think it makes sense to monitor it for now and get the biopsy when we've got insurance again or there is further change. I know everyone here has much bigger things going on and I value that you offered some insight into this uncertainty of mine. Since my mother's melanoma, I've tried my best to be prudent when taking care of my skin, but it can be hard to know when the biopsies are the right call.
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- October 26, 2016 at 1:21 am
Thank you so much for the replies, I genuinely appreciate it. I think it makes sense to monitor it for now and get the biopsy when we've got insurance again or there is further change. I know everyone here has much bigger things going on and I value that you offered some insight into this uncertainty of mine. Since my mother's melanoma, I've tried my best to be prudent when taking care of my skin, but it can be hard to know when the biopsies are the right call.
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- October 23, 2016 at 2:35 pm
Tough call. Unlikely that the lesion is anything other than benign although a biopsy might show some atypia now. Anything read through scar tissue will look worse that it might really be. Scar tissue can change the look of melanocytes. (Pathologists typically understand this but it bears noting). Shave biopsies are notorious for leaving behind cells so in the future, I suggest another method of biopsy. As for your current lesion, I'd probably monitor it closely. If it really continues to evolve and change significantly, I'd pay for the biopsy. Alternately, I'd have the biopsy once you regain insurance just to get rid of it. My doc (melanoma specialist) does not like any pigment regrowth in lesions and most likely would also suggest removal. But since it was benign, I'd probably wait until I had insurance to take care of it unless continued changes really indicated something more was going on. You have to do what makes YOU comfortable, no one else. (I recently battled expensive health issues with no insurance and I get it! Some expensive things I had to do immediately but did put off other stuff until I had insurance. No easy answers).
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- October 24, 2016 at 3:44 pm
Ive had one removed that was atypical and the mole like regrew in the scar. I thought it wadnt good either but my derm says regrowth is normal -
- October 24, 2016 at 3:44 pm
Ive had one removed that was atypical and the mole like regrew in the scar. I thought it wadnt good either but my derm says regrowth is normal -
- October 24, 2016 at 3:44 pm
Ive had one removed that was atypical and the mole like regrew in the scar. I thought it wadnt good either but my derm says regrowth is normal
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Tagged: cutaneous melanoma
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