Melanotic Tumor Research Articles

PRIMARY ORBITAL MELANOMA

Melanotic tumors of the orbit as a rule are secondary, arising chiefly from the uveal tract and less often from the conjunctiva, the piaarachnoid of the brain or a more distant focus. Carefully studied and described cases of primary orbital melanoma, with which this paper is chiefly concerned, are numerically few. A tedious search of the world literature back to 1838, when Raimbert published his case, disclosed that most reports are brief and pathologic studies either absent or incomplete. In the accompanying table the collected reports are tabulated and brief notes of criticism given. Eleven cases from the literature are summarized in the following section. REPORT OF CASES FROM THE LITERATURE Laurence's Case 1. —A woman aged 62 had increasing proptosis until, after nine months, the eye was outside the orbit. The eye together with an intimately adherent encapsulated melanotic tumor was removed. The growth promptly recurred, filling the orbit. In

PRIMARY MELANOTIC TUMORS OF THE MENINGES: RESEMBLANCE TO MENINGIOMAS

Primary melanotic tumors of the central nervous system are rare, and reports of no more than 30 cases have appeared in the literature. Even some of these are open to question because of the possibility that the tumors were secondary to some unrecognized origin elsewhere in the body. However, there appears to be substantial reason to assume that these tumors can arise in the meninges of the brain and cord. The great majority of cases reported have tended to conform, more or less, in that the tumors originated in the leptomeninges, invaded the adjacent neural parenchyma and spread along the subarachnoid spaces after the fashion of meningitis, ending in death in less than two years after the onset of symptoms. We have encountered at the New York Hospital 2 cases of primary melanotic tumor of the meninges—1 of spinal and 1 of cranial tumor. The growths were decidedly unlike those

Multiple primary melanomas of the small intestine

Multiple primary melanotic tumors (64 carcinomas (?)) of the small intestine were found in a man 35 years of age with the development of symptoms 9 months before death. Metastases occurred in the intestine, mesenteric lymph nodes and the heart. There being no other clinically or pathologically demonstrable primary source, it is assumed that the tumor started here from a possible mesoblastic type chromatophore.

Primary Melanotic Sarcoma of the Esophagus: Report of a Case

Primary malignant melanotic tumors of the esophagus are extremely rare, as evidenced by the fact that only three have been found in the literature, namely those of Baur (1), Joliat (2), and Voss (3). Metastatic melanomas however, are not unusual in the gastro-intestinal tract, where they may involve either the mucosa or submucosa. In the present case, as well as in those reported previously, the diagnosis of esophageal tumor was not made until after death, since there were no signs of esophageal obstruction. Case Report J. R., a man aged sixty-nine, entered St. Luke9s Hospital July 6, 1933, complaining of a feeling of fullness in the epigastrium and the expectoration of large amounts of mucus, over a period of six weeks. Expectoration was usually accompanied by some coughing, and occurred a few minutes after eating. There had been a loss of forty pounds in weight during this time. Thirty years before admission the patient had punctured the left eyeball. This healed promptly and produced a scar of the right cornea, which caused complete blindness in that eye. Since the healing of the eye there had been no further change in its appearance. Other than this the patient had always been in good health.

NEUROFIBROMATOSIS WITH OCULAR CHANGES AND INVOLVEMENT OF THE THORACIC SPINE

Pigmentation of the skin and multiple neurofibromas are characteristic of Recklinghausen's disease, but numerous other manifestations are seen. 1 Changes in the bone have been observed in cases of neurofibromatosis. Brooks and Lehman, 2 Castronuovo, 3 Camp, 4 Camp, Adson and Shugrue, 5 Gould, 6 Weiss, 7 Adrian, 8 and Stalmann 9 reported cases with various associated changes in the bone, including scoliosis, abnormality of growth, irregularity of outline, central and subperiosteal cysts, pedunculated subperiosteal tumors and pseudo-arthrosis. Siegmund 10 reported a case of neurofibromatosis with bony cavities of the lumbar and sacral vertebrae lined by herniations of the dura and accompanied by aneurysmal dilatations of vertebral arteries. Ocular changes associated with Recklinghausen's disease are also recorded. Goldstein and Wexler 11 described a case of melanotic tumors of the iris with orbital neurofibromas and called attention to the frequent occurrence of orbital neurofibromatosis accompanied by pigmented nevi of the lids,

A case of cerebral metastatic melanoma simulating cerebrospinal meningitis and encephalitis

1. A case of melanoma with visceral and intracranial metastases is reported. 2. The complex cerebral symptomatology and rather early changes in the personality of the patient are reported; and the clinical diagnosis of cerebrospinal meningitis and encephalitis which was offered in this case, is discussed. 3. The post-mortem examination revealing the presence of generalized metastatic involvement by a melanotic tumor and the presence of a skin lesion as a possible primary location of the tumor are brought out. 4. General histological features of the tumor tissue are given, and various theories concerning the origin of the tumor are reviewed.

Primary Malignant Tumors of the Foot

IN a period of nineteen years, during which time 10,459 cases of malignant disease were admitted to the Institute for study, we have been impressed with the relative infrequency of malignant tumors occurring in the foot. However, the frequency has been sufficiently striking to stimulate an interest in making an analysis of the various kinds of tumors which affect that member. In reviewing the literature we find several contributions to the study of tumors of the foot. Treves (1) reported a case of sarcomatous tumor of the sole of the foot in 1887; Shedden (2), in 1888, a case of epithelioma of the sale of the foot, with metastases in the lymph nodes of the groin; Jessett (3), in 1889, an alveolar sarcoma of the foot. Langdon (4), in 1894, Caubet (5), in 1903, Morestin (6), in 1905, Hertzler and Gibson (7), in 1914, have contributed articles on melanotic tumors of the foot, the latter giving extensive case reports, with a discussion of the histogenesis of the tumor. Kurtz (8), in 1930, reported a pigmented...

A Case of Melanotic Sarcoma of the Iris

This is an example of iritic tumor, which, suspected of being sarcomatous, was removed when enucleation was refused. In its later course it involved the whole anterior portion of the globe and enucleation was finally permitted because of the pain. The dissemination of pigment in the anterior chamber should be regarded as indicative of malignant melanotic tumor and enucleation strongly advised. From the German University Eye Clinic, Prague, Prof. Dr. A. Elschnig, Director.

BENIGN MELANOMA AND MELANO-EPITHELIOMA OF THE CHOROID

The type and origin of the cells in malignant melanotic neoplasms of the choroid have long been a subject of considerable interest. More recently, the relationship between such tumors and benign melanomas or pigmented nevi has received increasing attention. The possible malignant transformation of benign melanomas has been suggested by de Schweinitz and Shumway, 1 Wolfrum, 2 Moore, 3 Heine, 4 Dawson 5 and Mulock Houwer. 6 None of these observers was able, however, to give definite proof of such transformation. Scheerer 7 stated that malignant degeneration of a melanoma of the choroid has never been observed. Benign melanomas of the choroid are much more common than appears from a survey of the literature on ophthalmology. It seems from reported cases that malignant melanotic tumors of the choroid are more common than benign tumors. Schappert-Kimmyser 8 investigated histologically the occurrence of benign melanomas in eyes with and without

A Melanotic Tumour of the Lower Lid

A Melanotic Tumour of the Lower Lid

SUBUNGUAL MELANOMA

Subungual melanoma is given a somewhat inconspicuous place in the usual discussion of melanotic tumors. It appears to be a much more common lesion than the small number of reported cases would suggest. In four of the twenty-six patients with melanoma who were treated at the Barnes Hospital, the condition had its origin in the nail-bed. While Hutchinson1was the first to emphasize the lesion and give a lucid description of its clinical characteristics, attention had previously been given to it by other observers.2Hertzler3has recently published a careful review of the previously reported cases, to which he adds two. Since then, Jones4has described three, and Chauvenet and Dubreuilh,5one. I wish to add four, bringing the total of reported cases up to twenty-five. REPORT OF CASES Case 1. —A white laborer, aged 53, was first admitted to Barnes Hospital on Nov. 5,

MELANOMA (SARCOMA) OF THE EYE IN A SYPHILITIC RABBIT

A melanotic tumor developed in a defective eye of a syphilitic rabbit following repeated genital inoculations with Treponema pallidum. The appearance of the tumor coincided with the development of a syphilitic lesion in the same eye, suggesting a relation between the occurrence of the two lesions.

A MELANOTIC TUMOR OF THE LIP TREATED WITH RADIUM

It has been strongly advised, and by one whom we all rightfully regard as an authority on the use of radium in malignant growths, not to employ either radium or roentgen rays in melanotic tumors.¹Like all general rules, however, it is subject to exceptions, probably even in the mind of this authority. The following case shows a fortunate outcome in transgressing the rule. <h3>REPORT OF A CASE</h3><h3>History.—</h3> Nov. 6, 1918, a physician, aged 37, consulted us in regard to a dark, slate blue, circular spot about 3 mm. in diameter, lying deep in the exposed red part of the lower lip. It was near the cutaneous border in the median line, and had been first noticed perhaps four years before. He thought it had doubled in size in the past two years. It did not clear up on pressure, but became more distinct, and there was a

THE CHARACTER OF CHROMATOPHORES.

In regard to the origin of the cell masses characteristic of pigmented moles and in regard to the origin of the melanotic tumors of the skin, different views are still held. A number of pathologists believe in the epithelial origin of nevi and of melanotic tumors; others assume a mesodermal origin. The latter view is especially represented in the work of Ribbert.1He believes the melanotic tumors to be composed of in part modified chromatophores. All chromatophores he regards as of common mesoblastic origin, in accordance with the previously formulated theory of Ehrmann.2In view of this divergence of opinion, it might not be without interest to inquire what the actual stand of our present knowledge of the chromatophores is, and if it supports the view of Ehrmann and Ribbert. Without attempting to give a complete review of the literature on this subject, I shall limit myself to a brief

THE NATURE OF THE CELLS IN PIGMENTED MOLES.

Pigmented moles in various parts of the body not infrequently become the starting-point of melanotic tumors, often of exceedingly great malignancy and widespread metastasis. In 1871 Durante, in Italy, first advanced the view that the cells composing nevi are epithelial in origin and not mesodermal as held by Rokitansky and Virchow, and upon this basis he brought forward a theory of the origin of tumors in a matrix of embryonal cells, a theory which Cohnheim proposed quite independently three years later. More recently Unna, ignorant at the time of Durante's views, strongly advocated the genesis of nevi in epithelium, and since then, especially recently, much has been written on both sides of this question. The followers of Durante and Unna refer to the melanotic tumors arising in moles as melano-carcinomata or as nevo-carcinomata, whereas others continue to speak of them as melano-sarcomata. Recently, Abesser¹in Orth's laboratory in Göttingen,

Melanotic Tumour in a Cow

Melanotic Tumour in a Cow

Melanotic tumour of eyeball: Death from secondary growths

Melanotic tumour of eyeball: Death from secondary growths

48. The Contra-indications to the Removal of Melanotic Tumours, derived from the Examination of the Blood and the Urine.

48. The Contra-indications to the Removal of Melanotic Tumours, derived from the Examination of the Blood and the Urine.

A Case of Melanotic Tumour Developed near a Congenital Mole

A Case of Melanotic Tumour Developed near a Congenital Mole

ST. THOMAS'S HOSPITAL.: Melanotic Tumour growing from the Heel; Amputation of the Leg

ST. THOMAS'S HOSPITAL.: Melanotic Tumour growing from the Heel; Amputation of the Leg