Question about pathology
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Question about pathology

› Forums › Cutaneous Melanoma Community › Question about pathology

  • Post
    • February 24, 2017 at 6:28 pm
    casagrayson
    Participant

      I posted a link to a picture of a very ugly lesion on my husband's back in January.  
      http://s102.photobucket.com/user/casagrayson/media/fullsizeoutput_328c.jpeg.html

      He went to the dermatologist on the 9th and had it biopsied.  Against my wishes, doc did a shave biopsy, saying that he wanted to remove all of the lesion above the skin level.  Doc noted to rule out BCC/SCC on the visit report.  

      In-house dermathologist made the following report:

      Gross description:
      Received in formalin is a 1.2 x1.2 x 0.5 cm tan-gray fragment of skin.  Bisected and submitted in toto.

      Pathologic Diagnosis:
      Invasive Squamous Cell Carcinoma, Keratoacanthoma type

      We went back yesterday for a Mohs procedure.  Here is the visit report:

      
Indications for surgery:  Poorly defined margins, aggressive pathology

      Final defect measured 2.0cm x 1.5cm and extended to the fat.  Scarring was present at this stage.

       

      So, here's my question.  Husband has had two prior melanomas.  There are instances in the literature of nodular melanomas being misdiagnosed as SCC, Karatoacanthoma.  Should this specimen have been stained for S-100?  Should someone have mentioned checking lymph nodes (even if it is SCC)?  Am I being too paranoid here?  The depth of this lesion really worries me.  

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        • February 24, 2017 at 6:36 pm
        jennunicorn
        Participant

          The image looks very much like an SCC, so the pathology is probably correct. Just based off my own experience.

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