Hi doctor, Recently I had a mole that just felt funny. I went to my dermatologist and asked her to take a look. She was on the fence about it but decided to remove it given my history. I am blue-eyed, very fair, and my mother and maternal grandfather both had melanoma. She did a shave biopsy and the results came back as follows: junctional nevus with severe cytologic atypia and architectural disorder, inflamed pigmentary incontinence, a concerning melanocytic process with borderline qualities. It was recommended that the mole is excised with 5mm margins which I had done a few weeks later. I have two questions regarding this. First of all, my understanding is that melanoma can be tricky to diagnose in its earliest stages, so I am wondering if this could be melanoma. The word "borderline" in the path report has me the most concerned. My second question is whether or not I need anything else done regarding this mole. As I said, it was excised 5mm on all sides and the margins were clear. So, if it was an early melanoma, would there be any additional treatment?
Hi. I have evaluated your concerns and I think that you need to be applauded for your alertness. The steps that you have taken to manage the "funny" mole have been in the desired direction. You are right that moles can be tricky to diagnose in early stages. It so happens that they tend to be taken lightly and by the time, an individual seeks medical consultation, sometimes they have already invaded more areas. The term "borderline" in pathological reports indicate that: However, the mention of atypia and pigmentary incontinence leave little scope for doubt concerning diagnosis. In my practice, I have seen that pathologists tend to be conservative in their opinion. You took the best step to get the lesions removed. Now you only have to remain a careful observer watching for any unexpected growth, similar lesion elsewhere and follow up as advised by your doctor.