Delaney's Spitz On Her Arm - Our Big Scare

In late July, we took Delaney, 4 years old, in to see one of my dermatologists for a "wart" like growth we had noticed on her arm over the previous 6 weeks. I was going to start treating it with over the counter remedies but Dr Lindsay Finklea wanted to see it, in person, to make sure. She said it was a "spitz" and could be concerning in a child her age so she numbed the area with a shot and did a deep shave to cut it off on July 25, 2017 and sent it to a dermatologist pathologist. Delaney did so incredibly well and got to go get candy at 9AM! Dr. Finklea educated us that they don't know why spitz occur but let us know that from here on out when need to alert any dermatologist she sees that she has had a spitz so that it doesn't get confused with melanoma. We thought we were completely done and headed to the candy isle to celebrate at 8:45AM!

On July 27, we received the surprisingly news that the pathology report had come back "moderately abnormal" with several other scary terms associated with the spitz nevus. A Spitz nevus (Epithelioid and Spindle-Cell Nevus) is an uncommon, benign, melanocytic nevus that is usually acquired and has histologic features that overlap with those of melanoma. The scary part was that spitz  resemble malignant melanomas clinically and microscopically, so they are often excised as a precaution. When it came back "moderately atypical," instead of benign, that is when the concern came about. Dr Finklea had already called and spoken live with the pediatric dermatology specialist in San Antonio - Dr Browning, who is also a customer of mine.

Unfortunately Dr Browning was on vacation from July 29 until first thing this Monday morning. We did some research which was scary but turned it over to God and tried not to think about it all of last week. Proverbs 3:5 - "Trust in the Lord with all your heart and lean not on your own understanding." 

All week we prayed for a confident answer in moving forward, as this type of abnormal spitz, which both doctors have said "is one of the worst types that a pathologist likes to see in young children." Yes, melanoma is extremely are in children but the pathology report leaves a lot of ambiguity and the consensus is "abnormal spitz" in young children, are rare and not well studied.

We just left Dr. John Brownings office and my prayer for confidence in the next step was answered. We will have surgery this Friday to remove a much larger section that will be treated proactively as melanoma with margins. Then it will be sent to a pathologist that specializes this in Colorado, to be analyzed.

Surgery was at Methodist Stone Oak Surgery Center that Friday. Carter and Addie helped all week getting her comfortable with what to expect for surgery. They used words that didn't scare her and connected with her by saying that both of them had similar surgeries with tubes in their ears and it didn't hurt at all. It really was amazing to see God work through the 2 of them all week long. 

Delaney proved to be pretty anxious in pre-op. Although we were able to distract her, her pre-op nurse, Kathryn was an abolsut dream and made our experience wonderful as could me. Kathryn every insisted that Delaney's stuffed animal, "Slush," had matching booties and a cap, like Delaney. They ended up giving her some "giggle juice" that made everything in the world okay for Delaney, expect leaving our arms for the actual surgery.

Once surgery was complete, Dr Browning came to talk to us and said she did great and now it is just the waiting game for the pathology report for "about 2 weeks." 

Carter and Delaney reuniting after surgery day.

One day 14, I started calling both doctors at 8AM and by 2PM, Dr. Browning called me on the phone where he delivered great news. Delaney’s margins were clear and everything was good based on the pathology report he had in his hands. When I asked about what this meant for sweet Delaney’s future risk, he made it seem like because they got it all, there is NO increase concern as she grows up due to this one spitz neva. The past 4 weeks have definitely been one of the scariest times we have ever encountered since becoming parents 10.5 years ago and we are beyond thankful for the outcome. Delaney, along with all of us will continue to be living in SPF shirts, big hats and gallons of SPF sunblock for the rest of our lives.