Staging Question…
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Staging Question…

› Forums › Cutaneous Melanoma Community › Staging Question…

  • Post
    • September 3, 2013 at 2:00 am
    MattF
    Participant

      So I'm trying to find the answer and i'm not sure there is just one or if there may actually be seeral depending on who you ask. please let me know if you have a thought or a fact etc.

      I was diagnosed through FNA biopsy 2 weeks ago Metastatic melanoma Salivary Gland…old primary was 11 months ago at base of ear.

      1. Is Local Recurrence considered within 2 cm of original primary surgical scar…AND more importantly is it considered only CUTANEOUS? or could it be a lump/mass under the skin?

      So I'm trying to find the answer and i'm not sure there is just one or if there may actually be seeral depending on who you ask. please let me know if you have a thought or a fact etc.

      I was diagnosed through FNA biopsy 2 weeks ago Metastatic melanoma Salivary Gland…old primary was 11 months ago at base of ear.

      1. Is Local Recurrence considered within 2 cm of original primary surgical scar…AND more importantly is it considered only CUTANEOUS? or could it be a lump/mass under the skin?

      2. Is in transit considered outside 2 cm but before nodal basin…AND more importantly is it considered only CUTANEOUS? or can it be lump/mass under the skin?

      I guess im trying to analyze what I have going on. I have actually seen some sites that call in transit and local Recurrence as CUTANEOUS and anything under the skin as just metastatic. The doctors called it a mass within the salivary gland that is positive for metastatic melanoma. But the actual lump is about 2.5 cm from my original primary…and i'm not sure if there are nodes involved also…really just wondering where i stand 

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    • Replies
        • September 3, 2013 at 2:27 am
        Janner
        Participant

          In transits can be subcutaneous.  But I doubt this would be considered "local".  I would think going to a gland would be similar to a lymph node and local is typically considered cutaneous.  However, I think this would be "regional" and not throw you out of the stage III category.  Local/In transits are often subjective — it is best just to ask your oncologist his opinion and staging.  It seems like there can be a lot of "opinion" involved in the exact categorization.  Some docs may say local, others diagnose in transit.  I think this is definitely one of those more gray areas and your doc is going to be the best one to analyze your particular circumstances.

          • September 3, 2013 at 2:27 am
          Janner
          Participant

            In transits can be subcutaneous.  But I doubt this would be considered "local".  I would think going to a gland would be similar to a lymph node and local is typically considered cutaneous.  However, I think this would be "regional" and not throw you out of the stage III category.  Local/In transits are often subjective — it is best just to ask your oncologist his opinion and staging.  It seems like there can be a lot of "opinion" involved in the exact categorization.  Some docs may say local, others diagnose in transit.  I think this is definitely one of those more gray areas and your doc is going to be the best one to analyze your particular circumstances.

            • September 3, 2013 at 2:27 am
            Janner
            Participant

              In transits can be subcutaneous.  But I doubt this would be considered "local".  I would think going to a gland would be similar to a lymph node and local is typically considered cutaneous.  However, I think this would be "regional" and not throw you out of the stage III category.  Local/In transits are often subjective — it is best just to ask your oncologist his opinion and staging.  It seems like there can be a lot of "opinion" involved in the exact categorization.  Some docs may say local, others diagnose in transit.  I think this is definitely one of those more gray areas and your doc is going to be the best one to analyze your particular circumstances.

              • September 3, 2013 at 2:42 am
              MattF
              Participant

                I agree…and don't really know if it matters Local vs In Transit….???

                I do agree still "regional" as it is within the same basin…even if it is a gland…(I don't think that would be considered an organ)…all right side of head and neck.

                Doctor wont do any kind of staging until after the PET this week (for obvious reasons)…and until after the surgery (if there is one obviously if PET is bad then Parotid and lymph node Dissection may not be needed) as he wants to see what is taken out and have it all analyzed, then stage from there…good tissue? nodes? salivary gland? etc?

                I had thought that local is usually considered cutaneous…but everything does seem to be subjective.

                I'm going with the very real and optimistic stage III at the moment and we will see what happens over the next 2 weeks. 

                Currently only really feeling tired, sweats, little fever….but the worst thing is difficulty swallowing.

                • September 3, 2013 at 2:42 am
                MattF
                Participant

                  I agree…and don't really know if it matters Local vs In Transit….???

                  I do agree still "regional" as it is within the same basin…even if it is a gland…(I don't think that would be considered an organ)…all right side of head and neck.

                  Doctor wont do any kind of staging until after the PET this week (for obvious reasons)…and until after the surgery (if there is one obviously if PET is bad then Parotid and lymph node Dissection may not be needed) as he wants to see what is taken out and have it all analyzed, then stage from there…good tissue? nodes? salivary gland? etc?

                  I had thought that local is usually considered cutaneous…but everything does seem to be subjective.

                  I'm going with the very real and optimistic stage III at the moment and we will see what happens over the next 2 weeks. 

                  Currently only really feeling tired, sweats, little fever….but the worst thing is difficulty swallowing.

                  • September 3, 2013 at 2:42 am
                  MattF
                  Participant

                    I agree…and don't really know if it matters Local vs In Transit….???

                    I do agree still "regional" as it is within the same basin…even if it is a gland…(I don't think that would be considered an organ)…all right side of head and neck.

                    Doctor wont do any kind of staging until after the PET this week (for obvious reasons)…and until after the surgery (if there is one obviously if PET is bad then Parotid and lymph node Dissection may not be needed) as he wants to see what is taken out and have it all analyzed, then stage from there…good tissue? nodes? salivary gland? etc?

                    I had thought that local is usually considered cutaneous…but everything does seem to be subjective.

                    I'm going with the very real and optimistic stage III at the moment and we will see what happens over the next 2 weeks. 

                    Currently only really feeling tired, sweats, little fever….but the worst thing is difficulty swallowing.

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