Dermatologist Fails to Diagnose Skin Cancer

Case Overview

This case takes place in Illinois and involves a younger female patient who developed cancer. She presented to the defending dermatologist for evaluation of a mole on her right shoulder blade. A few days after her initial examination, the patient underwent a biopsy of the mole, and her dermatologist attempted to remove it using cryotherapy. Roughly 6 months later, the patient noticed a lump she developed in the area near her armpit. The lump was biopsied and was found to be metastatic skin cancer. It was determined that the original mole she had on her right shoulder blade was cancer and had not been properly excised. The untreated cancer was then able to metastasize. Due to the delay in diagnosis and delayed treatment of the initial mole, the patient’s options for treatment were vastly reduced.

Questions to the Cosmetics expert and their responses

Do you frequently examine specimens as described in the case summary?

I am a board certified dermatopathologist who practices at a major University Hospital with a busy cutaneous cancer center. We specialize in melanoma, merkel cell, squamous cell, and advanced basal cell carcinomas of the skin and we see a high volume of these types of patients.

How do you ensure the proper analysis/excision of the specimen, as described in the case summary?

Feb to May is a rather short time frame for spread and it indicates a rather aggressive tumor. I need to know more about the type of cancer and see the slides. Was obvious lymphovascular invasion not identified on the original biopsy? What was the path report on the original biopsy? The original pathologic evaluation of this tumor is key.

Are you able to review the records/slides to and opine, potentially testify, to your findings?

I would be happy to review this case.

About the expert

This expert is a board certified and fellowship trained dermatopathologist who has acquired membership in numerous professional societies including but not limited to the American Society of Dermatopathology, and she is extensively published and has been invited lecture to multiple professional conferences. Currently, she holds a high ranking dermatopathology Directorship position at her institution, and she has worked both in a private practice and academic setting.