How can a diagnosis be a metastatic melanoma when all that has been done is an excision?

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2/16/2012 2:44pm
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I haven't been on this site in about 9 years - I'm just over 10 years NED after a stage 1B melanoma on my ear.  Recently a friend of mine was diagnosed, but I thought it was odd that the Dr. told him he has metastatic melanoma, but the only thing they have done so far is an excision and biopsy.  It is 3mm, but without seeing the lymph notes or doing scans, how could you diagnose this as metastatic?  Am I missing something?

It was probably "malignant melanoma" as opposed to "metastatic melanoma".  Your friend didn't have a sentinel lymph node biopsy for a 3mm lesion?  Are you sure it was 3mm?  You're right, though, it isn't metastatic unless it was determined the lesion biopsied wasn't the primary site.  With no lymph nodes tested or scans - unless the biopsy wasn't the primary site - there is no way to determine at this point if anything is metastatic. 

Congrats on 10 years NED!

Janner

Hey,

Yeah, I agree with Janner, your friend probably misinterpreted what was said, completely understandable under the circumstances. I basically posted to congratulate you on your NED status, man that's great news. I always look to stories like yours when I get down, thanks fore the pick me up.

Gtown  

Hello,

I too was diagnosed with metastatic melanoma from the first biopsy.  This was a subcutaneous (under the epidermis) tumor that slowly developed from a small BB size to the size of a grape in 4 months.  It was originally diagnosed twice as dermato fibroma by my family Dr. and then dermatolagist.  At my request it was removed and biopsied and to the shock of my Dr.was metastatic melanoma.  I was sent to surgeon for wide excision who discovered three other tumors and said I would not benefit from this surgery as the melanoma has already metastasized from the original site and a systemic treatment would be needed.   I have an unknown primary, meaning: a lesion was never found on my epidermis.  I since have had 10 subcutaneous tumors removed that all start out so small they are undetectable until they grow to a size you can discover on your own.  So far,  they have been in places where they can surgically be removed.  I have tried several systemic treatments and no response so continue to have surgery to remove.  My dermatologist and surgeon both said that this is a rare way for melanoma to present itself, almost always starts in the epidermis.  It has taken me a long time to figure out the many characteristics of this melanoma with unknown primary but the good news is people who are diagnosed with unknown tend to have a longer survival.  Recently a post was made by Charlie S. who knows a lot about this particular presentation of melanoma with a lot of great links.  Please check it out and forward to your friend. There is so much to know about this cancer as it can manifest itself throughout the body and depending on where it is, treatment can vary so much, so always difficult to duplicate from patient to patient, everyone having a different circumstance and experience.  Hope this helps and good luck to your friend.