› Forums › General Melanoma Community › New, and worried about the latest biopsy report…
- This topic has 6 replies, 2 voices, and was last updated 13 years, 3 months ago by
casagrayson.
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- November 2, 2012 at 3:52 am
My husband has had two primary melanomas removed. I noticed an oddly pigmented area on his jawline that the dermatologist almost didn't biopsy; it was a shallow melanoma that was removed in 2002. This spring I noticed another flat, pigmented area on his scalp; it also was a shallow melanoma. Neither one of these were deemed to be serious nor was he referred to an oncologist. Last week he went back to the dermatologist because he had developed a nodule underneath the skin on his arm; it had been growing for over a month.
My husband has had two primary melanomas removed. I noticed an oddly pigmented area on his jawline that the dermatologist almost didn't biopsy; it was a shallow melanoma that was removed in 2002. This spring I noticed another flat, pigmented area on his scalp; it also was a shallow melanoma. Neither one of these were deemed to be serious nor was he referred to an oncologist. Last week he went back to the dermatologist because he had developed a nodule underneath the skin on his arm; it had been growing for over a month. A biopsy was done, and it came back as inconclusive. The specimen was sent off to a Univeristy for further evaluation, and those results came back as "recurrent basal cell carcinoma". I should be jumping up and down with joy, but I'm concerned because he has never had a basal cell carcinoma in that location! Is there any possibility that this could actually be a melanoma metastasis? He is scheduled for a Mohs procedure next week. Should we push for the "slow Mohs" given his melanoma history?
Thanks for any direction you can provide.
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- November 2, 2012 at 4:15 am
Melanoma and basal cell carcinoma are two different cell types. I think they are unlikely to be mistaken for one another. Melanocytes typically respond to a stain — and that stain would not color basal cells. In addition, if he were to have a metastasis from either of his primary sites, the arm would be one of the least likely locations. Lymph nodes in his neck or clavicle area or mets to his organs would be a more likely path that to pass several lymph basins and head "upstream" to an extremity. I'm not saying it can't happen, but given the fact that his primaries were thin, on the head and the diagnosed cell type is something MUCH different, all of this makes me think melanoma extremely unlikely. If this were me, I'd do the regular Mohs. Basal cells should show up under the frozen section pathology technique used in Mohs where melanocytes don't typically do as well. It is possible that the basal cell had only a very small presence on the skin. Often times, basal cell carcinoma can be much larger under the skin than on the surface. To me, that seems a much more likely scenario. Obviously, you need to do what makes your husband comfortable, but I personally would not be jumping on the melanoma bandwagon given the information you shared here.
Best wishes,
Janner
3 MM primaries, stage IB since 1992
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- November 2, 2012 at 4:15 am
Melanoma and basal cell carcinoma are two different cell types. I think they are unlikely to be mistaken for one another. Melanocytes typically respond to a stain — and that stain would not color basal cells. In addition, if he were to have a metastasis from either of his primary sites, the arm would be one of the least likely locations. Lymph nodes in his neck or clavicle area or mets to his organs would be a more likely path that to pass several lymph basins and head "upstream" to an extremity. I'm not saying it can't happen, but given the fact that his primaries were thin, on the head and the diagnosed cell type is something MUCH different, all of this makes me think melanoma extremely unlikely. If this were me, I'd do the regular Mohs. Basal cells should show up under the frozen section pathology technique used in Mohs where melanocytes don't typically do as well. It is possible that the basal cell had only a very small presence on the skin. Often times, basal cell carcinoma can be much larger under the skin than on the surface. To me, that seems a much more likely scenario. Obviously, you need to do what makes your husband comfortable, but I personally would not be jumping on the melanoma bandwagon given the information you shared here.
Best wishes,
Janner
3 MM primaries, stage IB since 1992
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- November 2, 2012 at 4:15 am
Melanoma and basal cell carcinoma are two different cell types. I think they are unlikely to be mistaken for one another. Melanocytes typically respond to a stain — and that stain would not color basal cells. In addition, if he were to have a metastasis from either of his primary sites, the arm would be one of the least likely locations. Lymph nodes in his neck or clavicle area or mets to his organs would be a more likely path that to pass several lymph basins and head "upstream" to an extremity. I'm not saying it can't happen, but given the fact that his primaries were thin, on the head and the diagnosed cell type is something MUCH different, all of this makes me think melanoma extremely unlikely. If this were me, I'd do the regular Mohs. Basal cells should show up under the frozen section pathology technique used in Mohs where melanocytes don't typically do as well. It is possible that the basal cell had only a very small presence on the skin. Often times, basal cell carcinoma can be much larger under the skin than on the surface. To me, that seems a much more likely scenario. Obviously, you need to do what makes your husband comfortable, but I personally would not be jumping on the melanoma bandwagon given the information you shared here.
Best wishes,
Janner
3 MM primaries, stage IB since 1992
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