Station - Instructions for candidate
You are a final-year medical student on a general practice placement in Kalgoorlie, running scheduled telehealth consultations from the practice consulting room.
Kevin Lim, a 52-year-old practice patient, is on the line for his scheduled result consultation about a lump taken from his back a fortnight ago. The laboratory report is attached to this sheet.
Histopathology report - right upper back lesion
| Item | Value | Reference range |
|---|---|---|
| Specimen | Excision biopsy, 12 mm pigmented lesion, right upper back | - |
| Diagnosis | Invasive melanoma, superficial spreading type | - |
| Breslow thickness | 1.4 mm | - |
| Ulceration | Present | - |
| Mitotic rate | 2 mitoses/mm2 | - |
| Lymphovascular invasion | Not seen | - |
| Peripheral margin | Involved at one point; closest clearance 0.5 mm | - |
| Deep margin | Clear at 2 mm | - |
Comment: Tumour invades the dermis to a depth of 1.4 mm beneath an ulcerated epidermis. Given the positive peripheral margin, this excision should be regarded as diagnostic and incomplete. Case to be discussed at the metropolitan melanoma multidisciplinary meeting.
Your tasks are to:
- Take a focused history.
- Explain the histopathology result to Kevin.
- Outline your initial management plan to Kevin.
- You do NOT need to summarise your findings to the examiner.
- You are not required to examine the patient in this station; this is a telehealth consultation.
- You do not need to write referrals, scripts or work certificates.
This is a 15-minute station, with 2 minutes of reading time.