Dr. Deepti Shukla
Venereology
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hello doctor,
I was diagnosed with polypoid malignant nodular melanoma with superficial spreading melanoma in the adjacent. Clark level 3, and 1.6 mm ulcerated. Would you be able to tell me if it being polypoid was more serious as I cannot find much information about it?
Hello,
Welcome to icliniq.com.
Polypoid melanoma is a subtype of nodular melanoma. It is the most aggressive type of nodular melanoma. So, yes, polypoid variant is more serious. In polypoid variant tumor growth occurs vertically that is why there is exophytic growth above the skin surface occurs causing polypoid variant. If you need any help or any more information, I would be happy to help you. I am hoping you are visiting a good dermatologist.
Patient's Query
Thank you doctor,
Your reply was wondering. What are the chances of spreading? I only had a wide local excision on my scapular. No slnb due to COVID-19 circumstances.
Hello,
Welcome back to icliniq.com.
Polypoid nodular melanoma has high chance of metastasis means high tendency to spread to lymph nodes or any organ. So during diagnosis biopsy of melanoma and lymph node biopsy are done. Lymph node biopsy can suggest whether metastasis has occurred or not. For tumor, usually wide excision is done to remove tumor tissue. But the good news is prognosis of melanoma over head, neck region is good. If you could share details of biopsy reports, all investigation reports, then I can advise you in a better way.
Patient's Query
Thank you doctor,
I had no lymph node biopsy due to COVID-19. The location was at right back of shoulder blade towards middle spine and on the level with armpit. 1.6 mm Breslow thickness, Clark level 3, extensive ulceration, mitosis 1 mm/2, lymphocytic infiltrate brisk. Wide local excision was fine. Have to be monitored every three months.
Hello,
Welcome back to icliniq.com.
Yes, I understand it is difficult due to COVID-19. As you mentioned 1.6 mm is intermediate growth so it is good but as ulceration was there that is not a good prognosis sign. That indicates chances of metastasis, so I would suggest you get lymph node biopsy done as soon as you get the opportunity. Please follow up regularly as it is important.
Patient's Query
Thank you doctor,
Do you know why polypoid melanoma is more serious than nodular?
Hello,
Welcome back to icliniq.com.
Polypoid melanoma is a variant of nodular melanoma only. I will explain it to you properly everything but you do not search on google because it always creates unnecessary worries. Polypoid melanoma is a kind of nodular melanoma only. Polypoid melanoma is a rapidly growing tumor, due to its rapid growth it has increased blood supply which increases the chances of metastasis. Also, as this tumor grows vertically, during surgical excision, deeper excision is needed. Also, as it is rapidly growing and most of the time presents on back, by the time patient notices and visit doctor, tumor already reaches to a higher stage. All these causes makes it more aggressive. That is why with early diagnosis and removal, the prognosis becomes better.
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Venereology
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