Wiggles

(I posted anonymously at first because the website collected my address when I created a login…I was concerned that that might somehow be accessible when I posted.)

Thanks to everyone who reached out to me! I wish that this forum didn’t need to exist, but since melanoma does exist I am so happy it does. I have been amazed with how tremendously supportive everyone is here. This is hard to find on the internet, in my experience.

The additional testing came back today as consistent with a compound Atypical Spitz Nevus and my doctor intends to cut .5 cm margins around the biopsy site. So good news, I think. I understand that Dr. McCalmont and his team at UCSF are experts on these things, but now I worry about the possibility of misdiagnosis. The diagnosis isn’t AST, it is “consistent with” AST, which sounds like hedging to me. So I wonder if there is still some question? And I worry about it being benign, but there is still a non-urgent need to go back and take margins? And yes, I am a natural worrier, as you might have guessed by now.

I still plan to switch insurance because I’ve had such a hard time getting my doctor to communicate with me through this time. I see an out-of-network doctor on 12/12 and expect to be able to ask questions then. I will ask him to do the excision in January. I’ll also ask him to look at my other spots that violate the ABCD rules, one of which looks like many of the pictures I see of melanoma in situ.

And importantly, I will take sun protection far more seriously, for myself and my children.

This warm and welcoming community has my gratitude.

Here is my the update to my pathology report:

Surgical Pathology Report
Addendum and/or Procedure Present

Addendum Reported: 11/20/2018

Addendum Diagnosis

SKIN, LEFT UPPER POSTERIOR LATERAL POPLITEAL FOSSA AREA, SHAVE
BIOPSY:
– COMPOUND PROLIFERATION OF LARGE MELANOCYTES, CONSISTENT WITH
AN ATYPICAL COMPOUND SPITZ’S NEVUS (SEE COMMENT)

Addendum Comment

This difficult case was sent to UCSF for second opinion. Dr.
McCalmont rendered the above diagnosis. A FISH assessment was
recommended to clarify the copy number status of CDKN2A and has
been completed. No homozygous loss was documented. Based upon the
other histopathologic findings apparent in the sections, including
partial maturation, good lateral demarcation, and a mostly nested
configuration, an unconventional or atypical melanocytic nevus is
favored as the best overall diagnosis.

Ref: J Cutan Pathol. 2012 Jan;39(1):25-8