Diagnosed Melanoma in 2011 and now masses in Liver.

[NicholasChupp]

Hey all,

I have a few questions. I'm a 28 YOM, fair skin, freckles, blonde hair, great physical shape but have been blessed with horrible skin.

In September 2011 I went to the Dermatologist for a skin rash (psoriasis) and during the full body examination the Dermatologist discovered a disturbing mole (large, dark, multi-colored) on my mid back. The Dermatologist removed the mole that day and the test results came back as Melanoma. Imagine my surprise, I have never had a single health problem in my life and my family has no history of any skin cancers.

Fortunately for me I have a fantastic Dermatologist who explained the Melanoma was very shallow (.2mm) and was able to remove the Melanoma with a wide excision.

Now, fast forward 17 months and 11 other mole removals. My Primary Care took some blood work and noticed one of my liver enzymes (SGPT) was mildly elevated (60). Since I had Melanoma she sent me to get a cat scan of the Liver, gallbladder, pancreas and all the other goodies in the RU quadrant. Well the results came back with 3 lesions in my Liver. So next on the list was a CAT followed by an MRI.

Both the CAT Scan and MRI radiologists diagnosed the lesions as atypical hemangiomas. I then went to see a liver specialist (GI) who took more blood work (which came back completely normal) and advised I do a follow up MRI in 3 months. I then went to my Oncologist who also did more blood work and made note that LDH, blood cell counts and liver functions were perfect. I then had a chest XRAY done to check for Lung lesions or swollen lymph nodes, also negative.

Here is the problem I'm having. I experience no signs (no night sweats, headaches, itching, etc) or symptoms of a recurrent Melanoma or even a secondary Melanoma. I have been looked over by 4 separate Dermatologists every 3 months for the last year and a half. I even had my Melanoma scar biopsied again for recurrence (negative).

My Oncologist is pushing me to get a PET scan done. Now, I'm all for having a PET scan done if there is a high risk of cancer. All the tests I have had done have been extremely positive though. My blood work is good, my liver function is good, there are no moles or skin spots that appear to be a secondary melanoma, no other lesions that I am aware of and no swollen lymph nodes. I also would owe out approximately $10,000.00 for the test to be done with my insurance.

I'm no Melanoma expert and for the most part I have stayed away from reading about it. I need advice now though from others who have experienced or have experience with Melanoma. Should I have this PET scan done? or should I wait another month and have the MRI done? am I reading too much into the positive signs? Are there other signs of  advanced Melanoma I should know about? Should I be more concerned?

Thanks in advance!

[Bhupinder Kaur, MD]

Hello,
I can understand your concern but chances of metastasis to liver are 50-77%. Unlike MRI and CT scans, which reveal the structure of organs, a PET scan shows how the organs and tissues are functioning. The technique has proven to be useful in screening for metastases of unknown location, determining the stage of the melanoma, and finding recurring tumors. So you should follow up with your oncologist and follow his advice.

It is very difficult to precisely confirm a diagnosis without examination and investigations and the answer is based on the medical information provided. For exact diagnosis, you are requested to consult your doctor. I sincerely hope that helps. Take care and please do keep me posted on how you are doing.

[NicholasChupp]

I guess it would have helped to add the size of my liver lesions. They are 7mm, 1.4cm and 1.4cm.