akamo

Thanks for the reply. He has decided on follow up appointments with the dermatologist. Do they check all your lymph glands? I am hoping it is something they will show us how to do. -Robin

Thanks for the reply. He has decided on follow up appointments with the dermatologist. Do they check all your lymph glands? I am hoping it is something they will show us how to do. -Robin

Thanks for the reply. He has decided on follow up appointments with the dermatologist. Do they check all your lymph glands? I am hoping it is something they will show us how to do. -Robin

Thanks for the replies. My husband will be glad to hear the length was necessary because he was in shock (my theory was too big is better than too small but then again, I am not the one with the excision).  He will also be glad follow up appointments are with the dermatoliogist. This has been a learning experience for us because he has always loved the sun and he has psoriasis so it has been necessary to keep it under control. We are going to make a life style change and along the way hopefully educate people about melanoma. -Robin

Thanks for the replies. My husband will be glad to hear the length was necessary because he was in shock (my theory was too big is better than too small but then again, I am not the one with the excision).  He will also be glad follow up appointments are with the dermatoliogist. This has been a learning experience for us because he has always loved the sun and he has psoriasis so it has been necessary to keep it under control. We are going to make a life style change and along the way hopefully educate people about melanoma. -Robin

Thanks for the replies. My husband will be glad to hear the length was necessary because he was in shock (my theory was too big is better than too small but then again, I am not the one with the excision).  He will also be glad follow up appointments are with the dermatoliogist. This has been a learning experience for us because he has always loved the sun and he has psoriasis so it has been necessary to keep it under control. We are going to make a life style change and along the way hopefully educate people about melanoma. -Robin

Extremely grateful for the reply! We have been back and forth on this trying to see if maybe we missed something or of course, not understand something. We are moving forward with no regrets. My husband is schedule for WLE on August 17th. THANKS AGAIN~Robin

Btw, I have read so many topics posted on here, and you are an amazing person to take the time and respond to so many people in need of support and answers.

Extremely grateful for the reply! We have been back and forth on this trying to see if maybe we missed something or of course, not understand something. We are moving forward with no regrets. My husband is schedule for WLE on August 17th. THANKS AGAIN~Robin

Btw, I have read so many topics posted on here, and you are an amazing person to take the time and respond to so many people in need of support and answers.

Extremely grateful for the reply! We have been back and forth on this trying to see if maybe we missed something or of course, not understand something. We are moving forward with no regrets. My husband is schedule for WLE on August 17th. THANKS AGAIN~Robin

Btw, I have read so many topics posted on here, and you are an amazing person to take the time and respond to so many people in need of support and answers.

Thanks for all the replies! So nice to have some one to talk to that understands.We have decided against the SNB surgery. I called the dermatologist's office and talked to a nurse and asked for reasoning behind the SNB surgery. She asked the doctors in the office and the only response she got was because the doctor ordered it (owner of the facilily). It is soooo confusing! The dermatology office is a very reputable office so I just don't understand. Anyway, here is the pathology report so if anyone has any comments and sees any reason my husband should have the surgery, please reply. Thanks! Robin

Skin, left abdomen, shave removal  –malignant melanoma, superficial spreading type,

invasive to clark's level II, breslow thickness .33 mm, nonulcerated.

COMMENT: The malignant melanoma is very close tho the lateral and deep edges of the biopsy. Further excison with appropriate surgical margins is recommended. Consultation may be indicated for Plastics or MOHS surgery. with or without frozen section technique.

GROSS DESCRIPTION: Skin, left abdomen; Submitted to the laboratory in a formalin-containing bottle labeled with patient's name and the anatomic site is a superficial piece of skin measuring .8 cm at the largest surface dimension and black in color.

MICROSCOPIC DESCRIPTION: Sections show skin with a poorly demarcated lesion composed of atypical melanocytes with large, hyperchromatic and pleomorphic nuclei and abundent cytoplasm. Single cells predominate over nests. Melaanocytic nests vary in size and shape and are haphazardly distributed at the dermal-epidermal junction. Single melanocytes are located throughout the epidermis, including the level of the granular layer, in a pagetoid pattern. Atypical melanocytes similar to those in the epidermis are present in the dermis. Melan-A and HMB45 stains highlight the melancytes. Ki-67 immunostain does not reveal increased proliferative activity in the lesional cells. A host mononuclear cell inflammatory response is present in the dermis. The following histologic variables pertaining to this tumor have also been identified:Thanks for all the replies! So nice to have some one to talk to that understands.We have decided against the SNB surgery. I called the dermatologist's office and talked to a nurse and asked for reasoning behind the SNB surgery. She asked the doctors in the office and the only response she got was because the doctor ordered it (owner of the facilily). It is soooo confusing! The dermatology office is a very reputable office so I just don't understand. Anyway, here is the pathology report so if anyone has any comments and sees any reason my husband should have the surgery, please reply. Thanks! Robin

Skin, left abdomen, shave removal  –malignant melanoma, superficial spreading type,

invasive to clark's level II, breslow thickness .33 mm, nonulcerated.

COMMENT: The malignant melanoma is very close tho the lateral and deep edges of the biopsy. Further excison with appropriate surgical margins is recommended. Consultation may be indicated for Plastics or MOHS surgery. with or without frozen section technique.

GROSS DESCRIPTION: Skin, left abdomen; Submitted to the laboratory in a formalin-containing bottle labeled with patient's name and the anatomic site is a superficial piece of skin measuring .8 cm at the largest surface dimension and black in color.

MICROSCOPIC DESCRIPTION: Sections show skin with a poorly demarcated lesion composed of atypical melanocytes with large, hyperchromatic and pleomorphic nuclei and abundent cytoplasm. Single cells predominate over nests. Melaanocytic nests vary in size and shape and are haphazardly distributed at the dermal-epidermal junction. Single melanocytes are located throughout the epidermis, including the level of the granular layer, in a pagetoid pattern. Atypical melanocytes similar to those in the epidermis are present in the dermis. Melan-A and HMB45 stains highlight the melancytes. Ki-67 immunostain does not reveal increased proliferative activity in the lesional cells. A host mononuclear cell inflammatory response is present in the dermis. The following histologic variables pertaining to this tumor have also been
 

Greatest thickness 0.33 mm

Level of Invasion Clark Level II

Growth phase vertical

Host response Non-brisk

Regression not identified

Mitosis Absent

Satelitosis Absent

Angiolymphatic Invasion Not identified

Perineural Invasion Not identified

Ulceration Not identified

Precursor lesion Not identified

Surgical Margins FREE

Thanks for all the replies! So nice to have some one to talk to that understands.We have decided against the SNB surgery. I called the dermatologist's office and talked to a nurse and asked for reasoning behind the SNB surgery. She asked the doctors in the office and the only response she got was because the doctor ordered it (owner of the facilily). It is soooo confusing! The dermatology office is a very reputable office so I just don't understand. Anyway, here is the pathology report so if anyone has any comments and sees any reason my husband should have the surgery, please reply. Thanks! Robin

Skin, left abdomen, shave removal  –malignant melanoma, superficial spreading type,

invasive to clark's level II, breslow thickness .33 mm, nonulcerated.

COMMENT: The malignant melanoma is very close tho the lateral and deep edges of the biopsy. Further excison with appropriate surgical margins is recommended. Consultation may be indicated for Plastics or MOHS surgery. with or without frozen section technique.

GROSS DESCRIPTION: Skin, left abdomen; Submitted to the laboratory in a formalin-containing bottle labeled with patient's name and the anatomic site is a superficial piece of skin measuring .8 cm at the largest surface dimension and black in color.

MICROSCOPIC DESCRIPTION: Sections show skin with a poorly demarcated lesion composed of atypical melanocytes with large, hyperchromatic and pleomorphic nuclei and abundent cytoplasm. Single cells predominate over nests. Melaanocytic nests vary in size and shape and are haphazardly distributed at the dermal-epidermal junction. Single melanocytes are located throughout the epidermis, including the level of the granular layer, in a pagetoid pattern. Atypical melanocytes similar to those in the epidermis are present in the dermis. Melan-A and HMB45 stains highlight the melancytes. Ki-67 immunostain does not reveal increased proliferative activity in the lesional cells. A host mononuclear cell inflammatory response is present in the dermis. The following histologic variables pertaining to this tumor have also been identified:Thanks for all the replies! So nice to have some one to talk to that understands.We have decided against the SNB surgery. I called the dermatologist's office and talked to a nurse and asked for reasoning behind the SNB surgery. She asked the doctors in the office and the only response she got was because the doctor ordered it (owner of the facilily). It is soooo confusing! The dermatology office is a very reputable office so I just don't understand. Anyway, here is the pathology report so if anyone has any comments and sees any reason my husband should have the surgery, please reply. Thanks! Robin

Skin, left abdomen, shave removal  –malignant melanoma, superficial spreading type,

invasive to clark's level II, breslow thickness .33 mm, nonulcerated.

COMMENT: The malignant melanoma is very close tho the lateral and deep edges of the biopsy. Further excison with appropriate surgical margins is recommended. Consultation may be indicated for Plastics or MOHS surgery. with or without frozen section technique.

GROSS DESCRIPTION: Skin, left abdomen; Submitted to the laboratory in a formalin-containing bottle labeled with patient's name and the anatomic site is a superficial piece of skin measuring .8 cm at the largest surface dimension and black in color.

MICROSCOPIC DESCRIPTION: Sections show skin with a poorly demarcated lesion composed of atypical melanocytes with large, hyperchromatic and pleomorphic nuclei and abundent cytoplasm. Single cells predominate over nests. Melaanocytic nests vary in size and shape and are haphazardly distributed at the dermal-epidermal junction. Single melanocytes are located throughout the epidermis, including the level of the granular layer, in a pagetoid pattern. Atypical melanocytes similar to those in the epidermis are present in the dermis. Melan-A and HMB45 stains highlight the melancytes. Ki-67 immunostain does not reveal increased proliferative activity in the lesional cells. A host mononuclear cell inflammatory response is present in the dermis. The following histologic variables pertaining to this tumor have also been
 

Greatest thickness 0.33 mm

Level of Invasion Clark Level II

Growth phase vertical

Host response Non-brisk

Regression not identified

Mitosis Absent

Satelitosis Absent

Angiolymphatic Invasion Not identified

Perineural Invasion Not identified

Ulceration Not identified

Precursor lesion Not identified

Surgical Margins FREE

Thanks for all the replies! So nice to have some one to talk to that understands.We have decided against the SNB surgery. I called the dermatologist's office and talked to a nurse and asked for reasoning behind the SNB surgery. She asked the doctors in the office and the only response she got was because the doctor ordered it (owner of the facilily). It is soooo confusing! The dermatology office is a very reputable office so I just don't understand. Anyway, here is the pathology report so if anyone has any comments and sees any reason my husband should have the surgery, please reply. Thanks! Robin

Skin, left abdomen, shave removal  –malignant melanoma, superficial spreading type,

invasive to clark's level II, breslow thickness .33 mm, nonulcerated.

COMMENT: The malignant melanoma is very close tho the lateral and deep edges of the biopsy. Further excison with appropriate surgical margins is recommended. Consultation may be indicated for Plastics or MOHS surgery. with or without frozen section technique.

GROSS DESCRIPTION: Skin, left abdomen; Submitted to the laboratory in a formalin-containing bottle labeled with patient's name and the anatomic site is a superficial piece of skin measuring .8 cm at the largest surface dimension and black in color.

MICROSCOPIC DESCRIPTION: Sections show skin with a poorly demarcated lesion composed of atypical melanocytes with large, hyperchromatic and pleomorphic nuclei and abundent cytoplasm. Single cells predominate over nests. Melaanocytic nests vary in size and shape and are haphazardly distributed at the dermal-epidermal junction. Single melanocytes are located throughout the epidermis, including the level of the granular layer, in a pagetoid pattern. Atypical melanocytes similar to those in the epidermis are present in the dermis. Melan-A and HMB45 stains highlight the melancytes. Ki-67 immunostain does not reveal increased proliferative activity in the lesional cells. A host mononuclear cell inflammatory response is present in the dermis. The following histologic variables pertaining to this tumor have also been identified:Thanks for all the replies! So nice to have some one to talk to that understands.We have decided against the SNB surgery. I called the dermatologist's office and talked to a nurse and asked for reasoning behind the SNB surgery. She asked the doctors in the office and the only response she got was because the doctor ordered it (owner of the facilily). It is soooo confusing! The dermatology office is a very reputable office so I just don't understand. Anyway, here is the pathology report so if anyone has any comments and sees any reason my husband should have the surgery, please reply. Thanks! Robin

Skin, left abdomen, shave removal  –malignant melanoma, superficial spreading type,

invasive to clark's level II, breslow thickness .33 mm, nonulcerated.

COMMENT: The malignant melanoma is very close tho the lateral and deep edges of the biopsy. Further excison with appropriate surgical margins is recommended. Consultation may be indicated for Plastics or MOHS surgery. with or without frozen section technique.

GROSS DESCRIPTION: Skin, left abdomen; Submitted to the laboratory in a formalin-containing bottle labeled with patient's name and the anatomic site is a superficial piece of skin measuring .8 cm at the largest surface dimension and black in color.

MICROSCOPIC DESCRIPTION: Sections show skin with a poorly demarcated lesion composed of atypical melanocytes with large, hyperchromatic and pleomorphic nuclei and abundent cytoplasm. Single cells predominate over nests. Melaanocytic nests vary in size and shape and are haphazardly distributed at the dermal-epidermal junction. Single melanocytes are located throughout the epidermis, including the level of the granular layer, in a pagetoid pattern. Atypical melanocytes similar to those in the epidermis are present in the dermis. Melan-A and HMB45 stains highlight the melancytes. Ki-67 immunostain does not reveal increased proliferative activity in the lesional cells. A host mononuclear cell inflammatory response is present in the dermis. The following histologic variables pertaining to this tumor have also been
 

Greatest thickness 0.33 mm

Level of Invasion Clark Level II

Growth phase vertical

Host response Non-brisk

Regression not identified

Mitosis Absent

Satelitosis Absent

Angiolymphatic Invasion Not identified

Perineural Invasion Not identified

Ulceration Not identified

Precursor lesion Not identified

Surgical Margins FREE

Janner,

Thank you for your reply and opinion. We feel the same way. I just don't understand why a doctor would tell us he needs a SNB, putting the fear in us that "if he doesn't have it done…..?". At the time we got his results and talked to the doctor, we had no clue what is was and now that we have done the reseach, I believe he will opt out of the SNB. The dermatologist that told him he was getting the SNB is from a large, well-known office in our area. He ordered full blood work, chest x-ray, and SNB with a wide local excision. We trusted it was all necessary and now wondering what to do next. Monday when the office opens, I am going to try and sort this out,

THANKS again!

Robin

Janner,

Thank you for your reply and opinion. We feel the same way. I just don't understand why a doctor would tell us he needs a SNB, putting the fear in us that "if he doesn't have it done…..?". At the time we got his results and talked to the doctor, we had no clue what is was and now that we have done the reseach, I believe he will opt out of the SNB. The dermatologist that told him he was getting the SNB is from a large, well-known office in our area. He ordered full blood work, chest x-ray, and SNB with a wide local excision. We trusted it was all necessary and now wondering what to do next. Monday when the office opens, I am going to try and sort this out,

THANKS again!

Robin

Janner,

Thank you for your reply and opinion. We feel the same way. I just don't understand why a doctor would tell us he needs a SNB, putting the fear in us that "if he doesn't have it done…..?". At the time we got his results and talked to the doctor, we had no clue what is was and now that we have done the reseach, I believe he will opt out of the SNB. The dermatologist that told him he was getting the SNB is from a large, well-known office in our area. He ordered full blood work, chest x-ray, and SNB with a wide local excision. We trusted it was all necessary and now wondering what to do next. Monday when the office opens, I am going to try and sort this out,

THANKS again!

Robin