A Name Change

I saw Dr. Fosko today along with a resident and a nurse. Maybe to clarify I should say they saw me. They saw nearly every inch of me. You know, there are very few people that can get away with that and not get slapped. The nurse took a picture of my tumor, the doctors stuck their fingers in my armpit and other places checking my lymph nodes, and I got asked rounds of questions including, "How can I get underwear like that?"

As for the diagnosis they say that it is a dermatofibroma (DF) spindle cell tumor. I looked up dermatofibroma and here's what I found. This does not cover the spindle cell tumor part of it. DF occurs more commonly in females with a male to female ratio of 1:4. It can occur in patients of any age but 20% occur before 17 years of age. Characteristics are pain and itching. DF forms most commonly on your legs, but second most commonly on your limbs. Historically it is believed to be caused by arthropod bites, however the cause of DF is unknown. Color can range from "gray, yellow, orange, pink, red, purple, blue, brown, or black, or a combination of hues." I was a little disappointed that there wasn't a green. I mean, come on, if you're going to cover everything else I think green is going to feel left out.


I also found this interesting bit of information about the spindle cell type of DF:
"Immunohistochemical testing with antibodies to factor XIIIa is frequently positive in DF, while antibodies to MAC 387 show less consistent results. The former antibody labels fibroblasts (dermal dendrocytes), while the latter labels monocyte-derived macrophages (histiocytes). Controversy exists as to whether the factor XIIIa positivity occurs within the actual tumor cells of DF or simply labels the reactive stromal cells; hence, the cell of origin for the spindle cell proliferation of DF is debatable. The cell surface proteoglycan, syndecan-1, may play a role in the growth of DF. Transforming growth factor-beta signaling might be a trigger of the fibrosis seen in DF."

Do you understand that? Yeah, me neither! No, basically I understood that they have no idea which cell type the dermatofibroma starts in in the spindle cell tumors. But that's really a pretty useless piece of information isn't it?

Here's an interesting fact.
"Factor XIIIa requires calcium as a cofactor."
See, Chris might be right about it being a calcium deposit.

I will be having Slow Mohs Surgery on the 14th of July. Regular Mohs Surgery conserves as much of the normal tissue as possible, but Slow Mohs Surgery is a little more aggressive. They will be removing a sizable portion of skin and it will not be sutured shut. YUM! They will send the tissue off to the pathologists and they will determine if the tumor has been completely removed. If there are still missing pieces to the puzzle I will go back and undergo Slow Mohs Surgery again, and again, and again until the tumor is completely gone. Some people go in once and some come back over and over again. I hope I'm the before mentioned. After all the tumor has been removed they will do reconstructive surgery. Until then I will have a huge (okay so maybe it won't be that big) hole under my arm. That should arouse some interest!