Severe dysplastic nevus

Question

At my regular full body exam, my dermatologist (dermatopathologist / MOHS surgeon) took off a small mole on my buttock.  I got a call from his office today saying I needed to come back for more to be removed  because the biopsy said  it was a severe dysplastic nevus with some pre cancerous cells.  The doctor cannot see me until next week and I'm terrified. 

Is this melanoma? What should I expect?  His nurse or whomever called, was quite short and quick to get off the phone with me before I could think of questions to ask!

maatson · Accepted Answer

most dysplastic nevi do not turn into melanoma . Most remain stable over time. Researchers estimate that the chance of melanoma is about ten times greater for someone with more than five dysplastic nevi than for someone who has none, and the more dysplastic nevi a person has, the greater the chance of developing melanoma.
 http://www.cancer.gov/cancertopics/factsheet/Risk/moles

The risk is much more in families with melanomas and dysplastic nevus syndrome FAMM Syndrome.

In a 10-year retrospective study, Marghoob et al. calculated that the risk of developing skin melanoma 
was 10.7% in patients with DNS compared to the 
controls, whose risk was 0.62%.

maatson · Answer

It was good to have removed the whole thing and you should now should not mind these checkups.
My best wishes.

diane493 · Answer

Had surgery today to remove any residual cells. My dermatopathologist (MOHS surgeon)  said this was 'serious' but was not cancer and not melanoma but would have become melanoma at some point. He also told me the surgery he did today was the very same surgery he would have done if it WERE early melanoma. Stitches out in 2 weeks. 

Full body checks every 3 months for 2 years and if nothing else is found, we'll move to 6 months if I feel comfortable doing that.

diane493 · Answer

One other question, does this mean I have a high chance of developing melanoma? I had a mildly dysplastic mole last year and then this. I have virtually no moles and only a few freckles, no family history and I take aspirin daily (supposed to reduce melanoma 30%) to prevent recurrence of colon cancer.

diane493 · Answer

I'm so glad you answered!  Words like 'severe' and 'pre cancer' have scared me so much AND I called my nurse help line with our insurance and this RN kept saying 'Be sure to find out the stage of your melanoma'.  That really blew my mind.

I had colon cancer in Jan. 2009 and all clear til Feb. 2012. In April 2012 I had 80% of my liver removed because of a solitary 1.5cm liver met (from the colon cancer) and after that, must have PTSD or some form of severe hypochondriac anxiety!  

Thanks for taking the time to answer me!

maatson · Answer

Complete or large excision of all clinically atypical naevi permits histological assessment of the entire lesion, and in most cases spares the patient the need for further surgical intervention.J Clin Patholv.57(11); Nov 2004.

As I can see in your case the pathologist is to take a look at the entire area by getting the entire tissue with a margin.

Despite the severe atypia it is no indication it is on the way to melanoma.
Family history, multiple dysplastic nevi syndrome are the negative factors towards progression.
Do keep cool and quite certain the problem should get solved with large excision.
Cheers.

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