Incidental minute intradermal nevus noted on pathology report

@tillymack
It seems you had a successful complete excision based on the notes. They found an incidental small intradermal Nevis which is a flesh colored benign mole. It seems this was removed with the excision. I have one that my dermatologist notes every year during my skin scan and is nothing really to be concerned about. They didn’t recommend removing mine. I also have a family history of skin cancers and had several suspicious moles removed/excised.

1. https://www.healthline.com/health/intradermal-nevus
2. https://www.clinikally.com/blogs/news/intradermal-nevus-unveiled-a-closer-look-at-this-common-skin-lesion

Thanks for your reply! Since posting my question I found the following online. Basically, I would like to confirm that the entire intradermal nevus was completely removed and potential malignant transformation if not.

A second surgery to excise a minute incidental intradermal nevus (a small, benign mole) is generally considered unnecessary if the first surgery was successful and the mole was completely removed. However, there might be a few reasons why a second procedure could be considered:

1. Incomplete Removal: If the first surgery didn't completely remove the nevus, leaving some remnants, a second procedure might be needed to ensure complete removal and prevent recurrence.

2. Recurrence: In rare cases, a nevus might return after removal, indicating incomplete excision during the first surgery.

3. Unclear Histopathology: If the initial biopsy or surgical margins weren't adequately assessed, a second procedure might be performed to obtain more tissue for a definitive diagnosis.

4. Cosmetic Concerns: If the patient is concerned about the scar or appearance of the first surgical site, a second procedure might be considered to address those concerns.

5. Malignant Transformation: While rare, there's a possibility of an intradermal nevus undergoing malignant transformation (e.g., melanoma). If a mole changes in size, shape, or color, or exhibits other concerning features, a second surgery or biopsy might be needed for evaluation.

Important Considerations:

Complete Removal:

The primary goal of nevus removal is to ensure complete excision to prevent recurrence and minimize the risk of malignant transformation.

Histopathological Evaluation:

It's crucial to have the excised nevus tissue examined by a pathologist to confirm its benign nature and rule out any signs of malignancy.

Scarring:

Surgery can leave a scar, and the size and appearance of the scar may vary depending on the surgical technique and individual healing factors.

Cosmetic Outcomes:

Cosmetic concerns should be discussed with the surgeon to determine the best course of action, which may include a second procedure or other treatment options.

In summary, a second surgery for a minute incidental intradermal nevus is usually not necessary, but it can be considered in specific situations, such as incomplete removal, recurrence, unclear histopathology, cosmetic concerns, or potential malignant transformation.

@tillymack
Your doctor and pathologist can tell you if the incidental intradermal nevus was fully removed with the original excision and if the borders were fully included. The pathologist can tell you if they fully tested the incidental finding for atypia.

If no further treatment is recommended or needed at this point, they may just continue to monitor the area of excision going forward.

Do you have a follow-up appointment scheduled to discuss the results and your concerns?