How often do pathologists miss melanoma? i have a mole that grew back and although the pathology was normal, i still want the regrowth removed. but it would require excision which is a bit excessive.

Not often...: A dermatopathologist (pathologist who specializes in dermatology) would not miss melanoma. Its very definable and as long as the depth of the initial excision showed "clean margins" along with no evidence of invasion of the questionable cells into the structures below (usually the fat) then you are ok. If its actually melanoma and there was complete excision then a lymph node biopsy might be done.

Mole: Pathologists do not usually miss melanoma.. Sometimes difficult lesions are hard to classify. However in your case the proper therapy depends on the clinical and pathologic diagnosis. If the lesion was normal, no further therapy is needed. If the lesion was a dysplastic nevus, it should be re-excised depending on the severity of the dysplasia. Excision is the usual treatment. It is not excessive.

Ask for 2nd opinion: It is not very frequent to miss a melanoma, but mistakes happen and if you have doubts about your diagnosis you should ask your physician to send the original mole to a different pathologist to give her / his opinion on the case. Do not be afraid to ask, I am sure your doctor will understand and you will feel more piece of mind. Best wishes, ariel.

Get 3rd opinion: Pigmented skin lesions are the most troublesome biopsies in pathology. The very fact of recurrence would make the original pathologist eager to have the glass slides seen by colleagues. Your physician can arrange this. And don't hesitate to have the lesion re-excised with a fair margin. A recurrent pigmented skin lesion probably looks nastier than any scar. Best wishes.

Melanoma: In general pathologists do an excellent job with an entire specimen. Please have it re-excised with an adequate margin. If there is concern over the scar please see a board certified plastic surgeon for a consult regarding this issue. The majority i my practice is devoted to the care of cancer patient and i will be sent patients frequently for consults of this nature and other reconstructive needs.

Second opinion: It would not be common. If you are concerned about your initial path you can always send it our for a second opinion by another pathologist.

Moles can recur: It is very important to be cetain that you don't have a melanoma; however, a mole does not have to be a melanoma to recur. The best treatment is excision with a small margin of normal skin. Nothing excesive. The pathology of the first specimen and the recurrence should both be reviewed.