Pathology Report for Two Moles

Forums Cutaneous Melanoma Community Pathology Report for Two Moles

  • Post
    sweatergirl
    Participant

      My hubby, age 55 with fair skin and numerous moles, went to the doctor for an unrelated matter when she noticed a mole the size of a pencil eraser on his left abdomen.  It appeared black; no uneven edges and not raised.  She used her special light on it and, because she found it to have "numerous colors," she referred him to a dermatologist on an emergent basis.

      Two days later he was at the dermo's office and the dermo found another worrisome mole, on his right shoulder.  Both moles were biopsied.  From the path report, it appears that they were shave biopsies.

      The diagnosis are as follows:

      a: Skin, left abdomen, biopsy:

      Compound melanocytic nevus, Clark's/dysplastic type, moderate to severely atypical, focally present at the peripheral margin, see comment.

      b: Skin, right shoulder, biopsy:

      Irritated compound melanocytic nevus, congenital pattern, see comment.

      Comment:

      A.  Definite full transformation into melanoma is not interpreted.  Nonetheless, there is moderate to severe architectural disorder and cytological atypia and consequentely full removal of any residual lesion is recommended. (scheduled for 11/4/15).

      B.  There is slight architectural disorder but no significant cytological atypia and the overall findingas appear benign.

      Specimen Submitted:

      A:  Left Abdomen: Received in farmalin labeled with the pt's name and "left abdomen" is a light tan skin shave with a central pigmentation.  The skin measures  0.8 cm x .7 cm.  The pigmented region is 0.5 x 0.4 cm located less than than 0.1 cm from the nearest resection margin.  The deep aspect is granular light tan.  The resection margins are inked blue.  The specimen is sectioned and entirely submitted in A1.

      B.  N/A since it appears benign.

      Unknown as to how long this particular mole was there, as hubby has so many.  From my research (thank you so much for this website–what a GIFT!), this was likely caught early enough so as to NOT be cancerous, but………

      My question to the group is how likely is this to be melanoma?  Hubby's parents have both had basal cell carcinoma and squamous cell carcinoma, but no family hx of melanoma.

      It would have been better if the dermo had initially done a punch biopsy v. shave, correct?  When she does the removal with two layers of sutures (as her medical assistant described), will it likely be the MOHS surgery or an excisional (like a lumpectomy, for a lack of better terms)?

      We will do full body photographs of moles, after this treatment, for comparisons.

      Thank you so much for reading my post and the feedback.

       

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    • Replies
        Janner
        Participant

          Most atypical moles will never become melanoma.  Watch for CHANGE.  Other skin cancers of his parents have no bearing.  Biopsy type is only significant if something is melanoma and then only if the lesion is bisected.  Staging information can be lost with a shave.  But a deep shave can be as effective as a punch especially if the lesion is larger and wouldn't fit in a punch.  MOHs is unlikely and not typically used for melanoma.  Excisional is best.

          Janner
          Participant

            Most atypical moles will never become melanoma.  Watch for CHANGE.  Other skin cancers of his parents have no bearing.  Biopsy type is only significant if something is melanoma and then only if the lesion is bisected.  Staging information can be lost with a shave.  But a deep shave can be as effective as a punch especially if the lesion is larger and wouldn't fit in a punch.  MOHs is unlikely and not typically used for melanoma.  Excisional is best.

              sweatergirl
              Participant

                Thank you for taking the time to respond. 

                I was afraid that the shave biopsy might compromise valuable information.  Thanks for the clarification. 

                Great feedback on the MOHs procedure as well. 

                It's difficult, being in unchartered waters. 

                sweatergirl
                Participant

                  Thank you for taking the time to respond. 

                  I was afraid that the shave biopsy might compromise valuable information.  Thanks for the clarification. 

                  Great feedback on the MOHs procedure as well. 

                  It's difficult, being in unchartered waters. 

                  sweatergirl
                  Participant

                    Thank you for taking the time to respond. 

                    I was afraid that the shave biopsy might compromise valuable information.  Thanks for the clarification. 

                    Great feedback on the MOHs procedure as well. 

                    It's difficult, being in unchartered waters. 

                    DZnDef
                    Participant

                      Yay!  Janner's back!  Congratulations Sweatergirl, your post was answered by one of the best.  Good luck to you!

                      DZnDef
                      Participant

                        Yay!  Janner's back!  Congratulations Sweatergirl, your post was answered by one of the best.  Good luck to you!

                        DZnDef
                        Participant

                          Yay!  Janner's back!  Congratulations Sweatergirl, your post was answered by one of the best.  Good luck to you!

                          _Paul_
                          Participant

                            Janner! Welcome back! This place isn't the same without you.

                            – Paul 

                            _Paul_
                            Participant

                              Janner! Welcome back! This place isn't the same without you.

                              – Paul 

                              _Paul_
                              Participant

                                Janner! Welcome back! This place isn't the same without you.

                                – Paul 

                              Janner
                              Participant

                                Most atypical moles will never become melanoma.  Watch for CHANGE.  Other skin cancers of his parents have no bearing.  Biopsy type is only significant if something is melanoma and then only if the lesion is bisected.  Staging information can be lost with a shave.  But a deep shave can be as effective as a punch especially if the lesion is larger and wouldn't fit in a punch.  MOHs is unlikely and not typically used for melanoma.  Excisional is best.

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