Inflamed Mole Biopsy. Is it Common to Send Back to Pathologist to Double Check? (photo)

Question

I had a shave biopsy done on an inflamed mole. The doctor thought I had scratched it after looking @ it w/ dermatoscopy, but I wanted it out. The biopsy came back w/ no atypical cells and inflammation. He sent the specimen back to the pathologist for 3 more slides to "double check" and "look deeper." Is this common w/ inflamed moles? Also, if it came back w/ no atypical cells, should I still be concerned about melanoma? or is atypia more likely? Aren't melanomas pretty obvious histologically?

Philip Young, MD · Answer

Melanoma can be a tricky diagnosis. You need the margins to be looked at to determine if there is melanoma present. Without atypia I think the concern is less. If it bothers you I would remove it to be certain. The diagnosis after removal is better under pathology.

Gary R. Culbertson, MD · Answer

No, most practioners do not ask a pathologist to take a second look. You are probably OK. It is unusual for a pathologist to change a diagnosis. Best,

	 

	Gary R Culbertson, MD, FACS

Richard P. Rand, MD, FACS (retired) · Answer

All your doctor is doing is being certain you don't have a skin cancer.  Any unusual healing after excision should be evaluated more thoroughly.

Mitchell Schwartz, MD - Account Suspended · Answer

While it is not uncommon to request deeper cuts on a biopsy, it is possible your doctor had some additional concerns based on his/her clinical observations. The initial report showing no atypical cells is certainly quite reassuring and deeper cuts are unlikely to change the diagnosis. Please use the ABCDE's as your guide for when to be concerned about moles: A for Asymmetry; B for irregular Borders; C for black or uneven Colors; D for Diameter greater than a pencil eraser; and E for a growth that is Evolving or changing. You can follow the video link below to learn more about identifying the changes in moles that are suspicious for skin cancer.

Inflamed Mole Biopsy. Is it Common to Send Back to Pathologist to Double Check? (photo)

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