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SEER Inquiry System - Report
Produced: 11/26/2024 3:14 PM
Question 20170018
Inquiry Details
References:
2007 MP/H Rules. Melanoma
Question:
MPH Rules/Multiple primaries--Melanoma: Does MP/H Rule M7 (diagnosed more than 60 days apart) apply to invasive melanoma cases with margins positive for in situ melanoma, or are these further excision of the original diagnosis and the same primary, even when it appears treatment was complete after the initial excision? See Discussion.
Discussion:
A dementia patient has been managed for a persistent right cheek skin lesion that has been slow growing for about 5 years. It was biopsied in 12/23/15 revealing a Breslow 0.12 mm lentigo maligna melanoma by an outside provider. A larger resection of the lesion on 2/3/16 demonstrated a Breslow 0.30 mm lentigo maligna melanoma with melanoma in situ present at the margins per the available pathology report. There was no statement in the record that any additional treatment was planned or necessary.
Patient healed well from the 2/3/16 procedure but developed a recurrent lesion in May that was biopsied on 5/10/16 by the same outside provider which again reveal lentigo maligna melanoma. 7/5/16 Reexcision at the current facility revealed a Breslow 6.1 mm lentigo maligna melanoma, Clarks level V. This was a cutaneous tumor per the path report and not a subcutaneous nodule. Clinically, the MD called this a , but there was no slide comparison to the previous melanoma.
In auditing files for expected (but not received) abstracts due from facilities, we've observed these types of cases not being consistently reported as multiple primaries.
Answer:
Rule M7 pertains to separate tumors. Rule M7 does not apply to invasive melanoma cases with margins positive for in situ melanoma.
Based on the information provided, it is not clear whether or not the 5/10/16 diagnosis is a separate lesion or the same lesion that was diagnosed earlier.
