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Dr. Nair
Dr. Nair, Dermatologist
Category: Dermatology
Satisfied Customers: 9156
Experience:  MBBS, MD (Dermatology, Venereology & Leprology)
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Had a flat mole on bottom arch of foot. Had a punch biopsy

Customer Question

Had a flat mole on bottom arch of foot. Had a punch biopsy on bottom of foot. They called me and said need to come in for further excision next week. Is this melanoma? Can you explain what this report means. This is what pathology report said. Sections show acral type skin. There is a compound melanocytic proliferation. There is a lentiginous proliferation of melanocytes between irregular nests. Scattered melanocytes show evidence of upward migration within the epidermis. In the papillary dermis, there are rare mostly single melanocytes that are best seen on MART-1/Melan-A. Additional deeper sections were obtained and reviewed. This lesion is present at the margin of the specimen.
Submitted: 1 year ago.
Category: Dermatology
Expert:  Dr. Nair replied 1 year ago.

Hello,

Thank you for your question. My name is***** and I will do my best to provide a useful input.

There are no clear cut features of a melanoma in your report. It describes a compound melanocytic nevus (which is just a regular mole) with some deeper extension as can be seen as these moles age. The reason you have been called in is to make sure all the mole tissue is removed and examined - there is 'lesion present at the margins' of the last excision which means it was not fully excised. Examining all the margins is important to make sure all mole tissue is examined for changes such as cytological atypia to conclusively rule out that there is no melanoma focus in this mole.

Please feel free to ask if you have any queries. I will be happy to continue further and do everything I can to provide you with the service you seek.

Customer: replied 1 year ago.
What does scattered melanocytes show evidence of upward migration within the epidermis mean? So when you read the report, am i correct to say that it doesn't show melanoma present from the biopsy taken
Customer: replied 1 year ago.
Thank you for explain the 1st part so that I could understand. Are there any questions I should ask the doctor when I go in. I will rate you highly
Expert:  Dr. Nair replied 1 year ago.

Upward migration shows the melanocytes are going towards the epidermis. This can be seen in both atypical moles as well as in early melanomas - in melanomas though these cells will invade the epidermis and replace the cells there. Also the cells moving upwards will show mitotic abnormalities and other atypical features of cancer cells. The stain used (e.g Melan-A) just identifies melanin producing cells and is not in itself an indication of whether these cells are cancerous or not.

I think that should cover it - there are no special questions I can think of to ask your doctor apart from his interpretation of the report.

Please feel free to ask if you still have any questions.

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