Case discussion: How would you treat this patient? [7 May]
This week we have another interesting case. What is your assessment of the clinical and dermoscopic pictures, and what would you do next? This lesion was on the upper back and the patient was unaware of it.
These are the results from the pathology report. What is your conclusion and what are the next steps you would take to treat this patient?
Sections show a pigmented seborrhoeic keratosis with an adjacent atypical junctional melanocytic proliferation amounting to at least malignant melanoma in situ of superficial spreading subtype. There is prominent inflammatory and established regression. Ulceration is not seen. Focally small numbers of atypical melanocytes are present within the papillary dermis in an area of regression. Dermal mitoses are not seen. While these may represent cross-cut junctional nests, the features are suspicious for early invasive melanoma, Clark level 2, Breslow thickness 0.2mm. In situ tuxmour lies 2.5mm from the closest peripheral margin and invasive tumour lies 5mm from the closest periphreal margin and 0.7mm from the deep margin.
R OF T2:
– MALIGNANT MELANOMA (CLARK LEVEL 2, BRESLOW THICKNESS 0.2MM)
We encourage you to participate in the case discussions and submit your own clinical images and questions, so we can all learn together.