Questions About Recent Pathology Report

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11/12/2010 3:11pm
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Replies: 8

It's been a while since I have posted on here.  Here is a little background on my family...My mom was diagnosed with MM 3 1/2 years ago with four primary melanomas (deepest one had her staged at IIC).  She moved to Stage IIIB after several intransit mets were removed near the site of one of her primaries.  She has been NED for 2 1/2 years and is doing great!  Six months after my mom's originial MM diagnosis, my sister was diagnosed with MM with two primaries.  Fortunately, she is staged at IA.  She has been NED since her diagnosis.  Doctors have suggested there is a good possibility of our family having the familial atypical multiple mole melanoma syndrome.  We have not done genetic testing.

With that being said, I have been closely monitored by my dermatologist twice a year for skin checks.  I have a number of biopsies done with 3-4 moles being mildly to moderately atypical.  I just recently had a mole removed from my upper chest area.  My derm called me today with the results.  That mole was moderately atypical, however, the mole also had some characteristics that melanomas tend to have.  She started telling me what those characteristics were, but she immediately lost me on that.  On Monday, I'm going to get her to fax me a copy of the path report.  The following week, I'm going for a re-excision. 

I was wondering, is this normal?  She said none of my other moles that were atypical had these characteristics.  Should I request to have another pathologist look at the biopsy?  I have always thought that an atypical mole was atypical and melanoma was melanoma.  She has really confused me!  Any advice would be appreciated!

Thanks,

Carrie

Carrie,

You said they are doing a re-excision next week. That will also be tested to make sure that they had gotten clear margins. That being said, if your concerned have a different pathologist read the slides!!  If your insurance won't cover it, expect it to be around $300 depending on the area of the country that you live in. Make sure to have a dermopathologist give the second read. 

I have had 6 primaries and many many atypical moles that needed re-excision. I've also had several that have been read by more than one pathologist! 

Keep a vigilant eye,

Linda

Thanks Linda for your reply!  Yes, they are doing the re-excision next week.  The thing that confuses me is when my derm mentioned the findings from the pathologist about the mole having certain characteristics of melanoma.  I just want to make sure whatever the mole is (whether moderately atypical or melanoma) is properly diagnosed.  Are there any dermopathologists that you (or anyone else that's reading) could recommend? 

 

Thanks again for your help!

Carrie

Carrie,

When we moved from Delaware to SC how I found my new derm was by finding a pathologist first. Then by e-mail he recommended a derm for me.  It was suggested to me by my derm at Hopkins to go on a local teaching hospitals website. Sure enough I found the info I needed.  Since then when I had my first bladder surgery I called my oncologist and she gave me a name of a dermopathologist to have the slide referred to.  Sure enough, the first pathologist at a local hospital called it bladder cancer, the dermo reread and said melanoma.

Last year many of us went to Chapel Hill NC for a symposium sponsored by MRF. They had a dermo from Calif as a speaker that said he constantly has slides sent to him from around the country.  I don't have his name but I'm sure if you e-mailed Tim he would have the name of that Dr. or someone closer to you.  Tim is the executive director MRF, he was at the conference and attends most.

tturnham@melanoma.org

Actually if you go to the listings under staff I would think any of them could help you with lists of Doctors.

I have had some severely atypical that were still not melanoma. I hope that your moms results are just atypical!!

Linda

Thanks again Linda for your response.  I'll email Tim to get the name of that dermopathologist and see if he has any others that he would recommend. 

I just want to make sure I get an accurate diagnosis.  I just feel like I can't be too cautious having 2 first degree relatives with multiple melanoma primaries. 

Thanks again for your help!

Carrie

Sometimes, melanoma in it's earliest stages is easily confused with other things like, spitz nevus.

While a good dermopathologist might be able to make something more of your slides, the main thing, the most important thing, is CLEAR MARGINS. You get that wider excision done, and get your clear margins. That's the most important thing.

The only good thing in having this family history is that you are very vigilant about getting anything suspicious removed.

 

I hope you get the best possible results

 

dian

I definitely agree with the clear margins.  When my derm called to discuss my biopsy results, I told her that there was no need to go conservative on the margins.  If she wanted to take more than protocol suggests, it's totally fine with me. 

I will update everyone when I hear results from the margins and second opinion of the original path report!

Thanks again Dian!

Wow Carrie...I wonder if you are just caught this mole as was turning into melanoma. Since it is common for moles to turn into melanoma, perhaps because of your family history and your being so proactive, you have actually caught one in the process of becoming cancerous. If so...good for you. That should give you the best possible prognosis. At least some good has come out of your mother's unfortunate experience.

Good luck...and keep up the good work.

Carrie 1
Melanoma 0

Mark from California

Mark,

I wish I could take credit for getting this mole removed...I have so many moles and lots of funny-looking ones.  I've never liked the way this particular mole looked, but there were others each time I went to the derm that looked more omnious.  When I went to my appointment last week, my regular derm had a family emergency and had to leave work, so they put me in with a different derm.  She immediately clued into the mole in question and removed it.  I think it was by the grace of God that I had that appointment with the new derm because my regular derm has never expressed concern over that mole.

I agree that some good has come out of my mom's diagnosis of melanoma.  If she had not been diagnosed with melanoma, I guarantee my sister would still be walking around with those moles on her that were melanoma.  It was my mom's diagnosis that scared her enough to have hers removed.  Fortunately, hers were staged at IA. 

Good luck with everything with you!  I've been keeping up with your journey since you've been posting.  Keep us updated.

Carrie