Pathology reports frame conversations between clinicians and patients. In the case of dermatopathology reports, in the best of circumstances, the histopathologist makes a clear diagnosis that aligns with a circumscribed menu of clinical implications. Subsequently, the clinician relays to the patient what has been found, and what the patient can expect as a result. Biopsies whose diagnosis is melanoma in situ can engender a range of such conversations. These can range from “your lesion is the earliest stage of melanoma but we’ve gotten it in time” to “the biopsy showed an early phase of melanoma, and if we don’t find anything more advanced when we get the rest of your lesion out, you’ll almost certainly be cured.” In the case of an elderly, debilitated patient with a large patch of melanoma in situ on the face, the conversation may be “this lesion is called melanoma, but removing it surgically may not be the best thing for us to do at this time.”
LeBoit PE. The Morphology of Tumor Progression in Melanoma In Situ. JAMA Dermatol. Published online May 08, 2019155(7):775–776. doi:10.1001/jamadermatol.2019.0457
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