Malignant Melanoma-Question of timeliness

My husband recently had two moles removed.  The one removed from the right blabella bridge/nasal bridge was reported as basal cell carcinoma & the doctor said she needed to do a further excision.

The second mole was from his left back; this mole had increased about 5 times its original size in a three month period, became raised, irregular, changed color, itched and had a red periphery.  The pathology was turned over for consultation due to difficulty of diagnosis.  Final diagnosis was atypical melanocytic neoplasm of uncertain malignant potential.  Histologically, features quite suggestive of atypical spindle & epithelioid cell nevus (Spitz nevus); however, leason displays mitotic activity.  Also, Spitz nevi are unusual in his age group (62) and possibility of malignant melanoma cannot be excluded.  Re-excision and clinical follow-up were recommended.

The doctor could not do the surgery prior to our leaving the state on Dec. 17th; surgery was postponed until January 14, 2000.  I am very concerned re: final diagnosis of malignant melanoma, although I presume if this is so, it should be in early stages?  My question is, should be wait until Jan. 14th or try to find other help?  We have an HMO plan which limits our choices but I am very concerned whether we are taking an unnecessary risk since I hear that malignant melanoma is a very aggressie and deadly cancer.

[Alan Rockoff, MD]

Betty:

It's hard to be too dogmatic about she like yours, since there are so many imponderables, such as what exactly the lesion is, what its malignant potential is or might become, and so forth.  One could never argue with removing it once, but it seems hard to justify insisting on that, especially given that you are not yet sure that it is a melanoma now. It is almost more of an issue of peace of mind.

You don't mention you her reason for leaving the state on December 17th (presumably it's holiday visiting.)If you and your husband are really anxious, I suppose you could consider postponing your trip, but the delay till mid January really does not seem excessive under the circumstances.

Good luck.

Dr. R