Re: Worried

Posted By
7/11/2014 3:37pm
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Replies: 2

Hello-

Earlier this month, I had what I thought was a small (2 mm) freckle removed from my leg. It was a dark brown and appeared to be getting larger.

Today I heard back from the dermatologist's office. They want to re-excise the area. I have a copy of the dermpath report and I am worried about what it says:

"There are features of evolving melanoma in situ. The lesion extends to the peripheral margins and to the base of the sections."

Under the heading "Microscopic description," it says, "Severely atypical melanocytes disposed as solitary units and nests are present within the epidermis and dermis."

I'm getting the re-excision done on Tuesday. What do I need to ask the doctor? Should I see an oncologist? Get a second opinion after the re-excision?

What are the chances this is melanoma? I'm so scared and worried.

Thank you all for your help. This board has been a great place of information so far.
Take care

Kim K - (7/12/2014 - 4:43am)

No need for onco at this time.  Sounds like a very abnormal looking mole / melanoma in-situ.  The fact that it is in-situ means it hasn't spread yet.  A wide excision and regular skin exams looking for change, "the ugly duckling" are all that is needed at this time.

Just make sure to have a good derm that will listen to you.  Avoid shave biopsies from this point forward in case another spot pops up.  Think of this as a shot across the bow so to speak, for vigilance.  The main concern is the development of another melanoma.

Was your report read by a dermatopathologist?  Just asking because that is where they earn their money.  These specialzed pathologists have extensive training on interpreting skin biopsies.  There is no such thing as a line that a mole crosses, rather a sliding scale of scariness.  Yours is in the gray area teetering on ugly nasty mole vs. very early melanoma.  Not a bad place to be in the great scheme of things.  Still scary, but that will get better with time.

Janner should respond to this post, if not you can look up her previous posts.  She does a great job on her stage I, II melanoma site.

You caught it early.  Good job!

Cancer Sucks Shit Happens Nothing is ever 100% bad, there is a reason and silver lining in everything. Sometimes I need a good light and my glasses to find it though. You can't fix stupid.

Gigipup - (7/12/2014 - 11:05am)

Thank you, Kim! Very helpful post.

It was a dermapathologist who read the report, and the report said that two doctors in the Derm office "concurred" with the reading of the report. So I guess that's all good.

I live in Florida. This is the first time I've been to this dermatologist, I have been to others in the past for annual check ups and other mole removals (all have been normal prior to now). I feel good about this Derm office. I also wonder if dermatologists in Florida see so much skin cancer that they are really knowledgeable. I hope so!

I do have other moles, but they all look alike (this last one looked very different). My current moles are all round and light tan/pink and kind of raised. Maybe five of them. They (and the offending bad mole) are all on a part of my leg where there is no pigment -- I was born without pigment on that part of my body.

I try to be vigilant but the sun is so strong here. I'm in the process of rethinking what I wear and sunscreen habits!