“Second opinion on biopsy?”
I had a brown mole about the size of a pencil eraser removed by shave biopsy around 2 weeks ago. I thought it might have changed shape and wasn’t sure so they biopsied it. I went yesterday for a follow up appointment to get the results. The dermatologist told me the initial diagnosis from the lab on the report is “compound melanocytic nevus” but the report also states it has been sent to a different pathologist for another review. I’m now waiting for those results since my office hasn’t gotten them yet. They said they should have it next week. Is this a bad sign, that the lab is sending it for another opinion?
Female | 27 years old
8 Answers
Candido Otero
Pathologist
A compound melanocytic nevus can be found in association with melanoma. Since this is a pigmented lesion that could be turned into a melanoma, the pathologist asks for a second opinion to ascertain that the cells he or she are looking at are not malignant. Also, depending on how many atypical (distorted) cells are seen in the sample, additional consideration by another pathology should be attained to rich the final diagnosis. If melanocytic nevi are not diagnosed, the prognosis could be poor. So, it is prudent to wait, and the more eyes sees your biopsy, the more accurate diagnosis you will have at the end. Large congenital melanocytic nevi are associated with an increased risk of developing cutaneous melanomas, leptomeningeal melanomas, neurocutaneous melanocytosis, malformation of the brain, and, rarely, rhabdomyosarcoma and liposarcoma. The treatment is excision. Thank you.
I believe that the lesion you had is most likely a benign compound nevus and you don’t worry about. However, the worst scenario it may turn out as a dysplastic nevus. If the lesion is completely excised with free margin, you don’t need to worry about it except for a close follow up!
No it’s not a bad thing. They are looking for atypical cells and might be doing gene testing or special stains. Be patient. Generally these are ok
Not necessarily. I would just wait until you hear back from the other pathologist and go from there.
Not necessarily. Maybe they want a second opinion to eliminate an atypical Nevus, then readdress the course of follow up or treatment if further needed.
Stephen Ovanessoff
Pathologist
Melanocytic skin lesions, can be benign or malignant. It is not unusual for a pathologist to seek second expert opinion on a case, since some of these lesions may have borderline atypical features that are difficult to interpret as benign or malignant by a general pathologist. For such cases it would be prudent to request the opinion of an expert dermatopathologist.
Melanocytes lesions (moles) can be very difficult to diagnose properly, that is why there are sub specialists called “dermatopathologists”. It does take about a week to get a second opinion, mostly due to shipping times.
It is not necessarily a bad sign, if anything it means that the pathologist is being thourough. The good thing is that the initial pathologist did not call it “melanoma” which would be a malignant diagnosis.
It is not necessarily a bad sign, if anything it means that the pathologist is being thourough. The good thing is that the initial pathologist did not call it “melanoma” which would be a malignant diagnosis.
Happens all the time. We like to confirm a diagnosis when we can.
