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22 Year Old Diagnosed With Atypical Spitz After Two Consultations

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Posted on Thu, 6 Oct 2022
Question: 22 year old diagnosed with atypical spitz after two consultations with dermatapathologists. IHC and FISH (which was negative) were also done.
Deep margins involved and doc mentioned “abnormal nuclei,” which is why this spitz is “atypical” and not just a regular spitz.
Complete excision recommended to get clear margins. Dermatologist said no other treatment needed.
I read that these are in between a regular harmless mole and a melanoma, but doctor assured me this isn’t a melanoma. Said complete excision is advised since these can come back and be hard for a pathologist to interpret.
Do you agree with this assessment and management?
doctor
Answered by Dr. Dr.Dorina Gurabardhi (14 hours later)
Brief Answer:
I agree with the management

Detailed Answer:
Hello dear,
I read carefully your query and understand your concern.

I completely agree with the assessment and management.
In case that abnormal nuclei are noticed the treatment consists in surgery and excision to remove the spitz up to the normal tissue around it.

Hope my answer was helpful.
If you have further queries feel free to contact me again.

Kind regards!

Dr.Dorina Gurabardhi
General &Family Physician
Above answer was peer-reviewed by : Dr. Dr. Yogesh D
doctor
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Follow up: Dr. Dr.Dorina Gurabardhi (30 minutes later)
Thank you.
This lesion had “deep margins involved” according to the Pathology report. I think the side (lateral margins were involved also.).
This was what I expected because the doctor who did the biopsy said the lesion was “wider and deeper” than he cut.

Here’s my follow up question- what are the chances that the residual lesion will show features that will change the diagnosis? (Pathology report did note that the sample was “adequate.” (Am i to assume it means it was adequate for assessing the lesion and running the necessary tests on it such as the immuniohistochemical stains?)
doctor
Answered by Dr. Dr.Dorina Gurabardhi (23 hours later)
Brief Answer:
Follow up

Detailed Answer:
Hi again dear,

If the sample is adequate, the residual lesion will probably have the same diagnosis.
So, the excision up to the normal tissue will be proper treatment.
I recommend regular check ups at your doctors clinic.

Hope it helps.
Take care,
Dr.Dorina Gurabardhi


Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
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Follow up: Dr. Dr.Dorina Gurabardhi (5 hours later)
One last question please:

I don’t exactly understand how a lesion can be in between a regular mole and a melanoma and still be benign. Can you clarify that please.
doctor
Answered by Dr. Dr.Dorina Gurabardhi (19 hours later)
Brief Answer:
Follow up

Detailed Answer:
Hi again dear,

Melanomas usually have ragged border. They usually have a mix of 2 or more colours.
Melanoma can spread in other parts of the body, and this is why they are considered malign.
In case that a lesion have partly some of the characteristics of melanoma but don't spread in the body, it is considered benign.

Hope it helps.
Take care,
Dr.Dorina Gurabardhi
Note: For further follow up on related General & Family Physician Click here.

Above answer was peer-reviewed by : Dr. Dr. Yogesh D
doctor
Answered by
Dr.
Dr. Dr.Dorina Gurabardhi

General & Family Physician

Practicing since :2013

Answered : 13592 Questions

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22 Year Old Diagnosed With Atypical Spitz After Two Consultations

Brief Answer: I agree with the management Detailed Answer: Hello dear, I read carefully your query and understand your concern. I completely agree with the assessment and management. In case that abnormal nuclei are noticed the treatment consists in surgery and excision to remove the spitz up to the normal tissue around it. Hope my answer was helpful. If you have further queries feel free to contact me again. Kind regards! Dr.Dorina Gurabardhi General &Family Physician