Melanoma Recurrence near Original Mole?

Posted By
JRM
1/3/2018 7:12pm
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JRM
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Replies: 2

Hello everyone, I am new to the MRF Forum, but thought it beneficial to be more proactive regarding my past melanoma, even though I have been clear for five years. I was first diagnosed with melanoma stage 1 in 2013 and had a wide excision of the lesion on my upper left arm. My margina came back clear the first time around. Over the last several years and with many other moles removed, I have been seeing my original diagnosing dermatiologist twice a year for mole checks.

Today, I had two suspcious moles removed near the original melanoma scar. My dermatologist thought they were atypical nevi and did not seem too worried,  but they both had black spots within the moles. My question to everyone: how common is it to have a recurrence of early stage melanoma near an original site? If my biopsies come back positive this time around, I would imagine I would have a wide excision surgey again. Would a PET scan be advisable now?  Has anyone had experience with this? Many thanks and best wishes for good health and happiness in 2018! 

So there are three things here.  One, these may be nothing and there is no reason to start planning for the worst.  Second, these may be new "primary" sites (if either happen to be melanoma) and that would mean they are unrelated to the original lesion.  Or third, they could be a recurrence of the original.  Recurrences don't typically look like a mole, however, although it is always good to check things out. 

So if they are nothing, continue on.  If they are new primaries, then a WLE/SLNB depending on depth.  If this is a recurrence of the original, then further evaluation might be needed.  A PET scan isn't useful in looking for new primaries, it is only good for showing tumors measuring about 5mm or larger.  And unless one of these things would change your staging, it's unlikely a PET scan would be warranted.  New primaries only change your staging if they are worse than your original - in other words you are the stage of your highest primary stage.  I've had an in situ, stage 1a and stage 1b primary so I am considered stage 1b.

In determining tne makeup of a new primary vs a recurrence, one of the things the pathologist looks at is the growth patterns.  In the very simplest terms, new primaries tend to grow from the top of the skin downward into the dermis.  And a recurrence grows from the lymph vessels deeper in the skin either thru the dermal tissue and possibly upward to the surface.

Let us know how it goes, but don't start planning for the worst until you have confirmation it is warranted!

Thank you very much for your thorough feedback regarding the staging of melanoma. This information has eased my anxiety for the time being. I will update this post when the biopsies come back. Best wishes for your health as well!