Wife referred for plastic surgery following biopsy?

In December 2018, my wife attended a dermatology appointment to discuss her PMLE (polymorphic light eruption). Following an examination of her skin and my wife pointing out a couple of moles to the doctor, she was referred for surgery the moles to be removed within two weeks and a biopsy conducted. She went for her surgery on New Year's Eve and had a mole from her back and leg removed. She was told that if the results came back clear, she would receive a phone call. My wife didn't receive a phone call and instead, she received a letter at the end of January asking her to come back to the dermatologist.

 

My wife and I attended the dermatologist for her results at the beginning of February and was told that her biopsy results had been discussed at a meeting with cancer specialists and determined she had something called 'spitzoid naevus'. She didn't really explain what this was, other than saying it is a "hyperactive mole". She stated that as they cannot be certain that it isn't melanoma due to the similarities between the two, she is being referred to a plastic surgeon to have more skin removed and sent for further tests.

 

My wife has already been left with a large scar on her back and on her leg and is now even more anxious that she is going to have those scars opened again and be left with even larger scars. For anyone who has been through a similar process, do the actions taken so far sound right? My wife hasn't had much confidence in her dermatology doctor whilst being treated for PMLE and having attended her last appointment with her, I have to agree.

 

I am now having sleepless nights, which I'm keeping from telling my wife as to not worry her, as I can't help but think that the doctor suspects she does, in fact, have cancer and is hiding that fact until further tests are conducted. I may be thinking into the situation too much as we are in the unknown but any advice or guidance would be appreciated.

 

Thanks,

Zach

  • Hi Zach,

    I'm sorry your wife is going through this & you are both naturally very worried. Can I say that the further surgery is always the next step in anyone with a spitzoid or a cancerous mole. It's called a Wide Local Excision (WLE) and they take a safe margin of tissue from around the mole to ensure that no cancer cells have broken off & are in the tissue. Because a spitzoid naevus can sometimes be a spitzoid melanoma the consultant is ensuring the whole area is removed, just in case (belt & braces are we call it). 

    As for the extent of the scar, this link gives you an idea of the size & shape that will be taken dependant on the depth of the mole that was removed skincancer.net/.../

    I know your wife doesn't want larger scars on her back & leg however they will heal well over time (I have had 8 moles removed over the years & some scars you can hardly see). It's better to be safe & completely remove a spitzoid, just in case it comes back as having melanoma cells in it, so I'm afraid the scars are something we put up with. Some of us joke as to where we got them (attacked by a crocodile) but in the main we are thankful to get rid of the offending mole!!

    Regarding confidence in the dermatologist, your wife can always ask to see another derm at the hospital if she's unhappy or, in the unlucky event the results show melanoma cells, further treatment & check ups will be necessary so she will have an option to just be cared for by the Plastic Surgeon if she wishes. However, some Plastic Surgeons aren't brilliant at doing mole checks (the regular body check at the 3 monthly appointments) but it's what derms are best at. Is it their manner that you aren't happy with? I know some consultants can be abrupt & appear uncaring. If it's their clinical experience you are unhappy with then maybe ask to see a different derm at the hospital.

    I hope it all goes well & the results come back clear. Please let us know how you both get on. 

    Angie (melanoma patient)