Introduction

It is axiomatic, as Moser [1] stressed, that medical “truths” have historical perspectives. Therefore, consider “melanoma.” This cancer is characterized as being pigmented and as having crept into the English language in 1838 [2]. Now, since [1] pathologists started to publish the Transactions of the Pathological Society of London in 1846-48, [3] and [2] a famous German pathologist, Julius Cohnheim [4], considered that Nature shows her footsteps when necropsies are carried out, what has transpired between 1848 and the end of that century? This paper answers this question with a series of recorded cases.

Historical texts

Rickman Godlee [5] stood out with a confession. As he put it, “I must express my regret that the spinal cord was not looked at, and that none of the bones were sawn through.” Likewise, Payne [6] was pained that, though the tumors were “deeply pigmented, some very black,” the only internal organs found were the liver and the lungs [6].

Battle [7] remarked that the secondary deposits were “universal” and included bones. On his part, Beadles [8] was brief. The vertex of the skull exhibited, he noted, “a commencing growth.”

Between the scalp and the brain convolution, as Ogle [9] observed, there was intervening bone involvement, although both structures were unscathed. However, in the experience of Targett [10] both the base of the skull and the dura mater succumbed.

Rolleston [11] had a wider experience. Thus, there were deposits in the third and fourth left ribs. In particular he noted the following links: He had left hemiplegia from the pressure of a growth which, starting in the right parietal bone, had penetrated the skull, depressed the dura mater and surface of the cortex, and at one point had penetrated the dura mater, and formed a polypoid tumour which was embedded in the substance of the right cerebral hemisphere.

Sanderson [12] saw, on both sides of the vertebral column, its associated group of growths thus: a number of tumors, varying in size from that of a pin’s head to that of a large walnut. These were most abundant on the left side, where they formed a chain connecting the spleen with the kidney and extending from the latter into the pelvic cavity.

In the experience of Legg [13] the connection was between “the ribs, near the vertebrae.” Turning to Fagge [14] he presented two cases in one of which the combination of deposits was “in the dipole of the calvaria and sternum.” Calvert and Pigg [15] observed the colonization of numerous sites including the lumbar vertebrae.

Discussion

It is noteworthy that the weighty tome of Willis [15] considered miscellaneous secondary tumors of bone but, under melanoma, gave only references which appeared in 1907, 1912, 1922, and 1928. In my contribution to the American Book on “Bone Metastasis” [16] mine was the Introductory Chapter. Interestingly, in the references in it demonstrated, I included some above cited works of Godlee [5], Rolleston [11], and Legg [13]. Here, it is apposite to draw attention to the very ordered reasoning concerning the entire metastasis phenomenon. This was expatiated on by the first of them as follows:

Conclusion

In conclusion, I would say that these pigmented tumours, when they fall in our way, are worthy of very careful observation. We are able to detect the first appearance of a new growth in any part, and it is evidently these very minute ones which afford the best opportunity of studying the method of development of this particular disease, and probably of throwing light on the origin and progress of sarcomata in general.

1. Moser KM (1987) Medical truths in historical perspective. Heart Lung 16(4): 345-346.
2. Merriam -Webster’s Collegiate Dictionary. (11th edn) Merriam-Webster Inc., USA, pp. 419.
3. Anonymous. 1840-48 BYE-LAWS AND REGULATIONS. Trans Path Soc Lond: 1: 15.
4. Cohnheim J (1889) Lectures on general pathology. (Section 1) London. The New Sydenham Society. p. 14.
5. Godlee RJ (1874) Melanotic sarcoma in the medulla oblongata secondary to a similar growth situated probably in a lymphatic gland. Trans Path Soc Lond: 25: 18-23.
6. Payne JF (1873) Melanotic sarcoma occurring in the liver, lungs, and other parts. Trans Path Soc Lond 24: 134-137.
7. Battle H (1895) Primary melanotic sarcoma of clitoris. Trans Path Soc Lond 46:189.
8. Beadles CF (1894) A case of multiple malignant growths. Trans Path Soc Lond 45: 188-197.
9. Ogle JW (1856) Melanotic carcinomatous deposit connected with the dura mater, the lining of the ventricles, and the seventh and ninth pairs of cranial nerves. Trans Path Soc Lond 7: 5-8.
10. Target JH (1891) Secondary melanotic sarcoma of the bladder. Trans Path Soc Lond 42: 214-215.
11. Rolleston HD (1897) Secondary polypoid melanotic tumours in the mucosa of the small intestine. Trans Path Soc Lond 48: 82-83.
12. Sanderson (1855) Melanotic cancer in various organs. Trans Path Soc Lond 6: 324-329.
13. Legg JW (1878) Melanotic sarcoma of the eyeball; secondary growths in the organs of the chest and belly, particularly in the liver. Trans Path Soc Lond 29: 225-229.
14. Calvert J, Pigg S (1898) A case of melanotic sarcoma. Trans Path Soc Lond 49: 297-299.
15. Willis RA (1973) The spread of tumours in the human body, London. Butterworths p. 194.
16. Onuigbo WIB (1981) Historical concepts of cancer metastasis with special reference to bone. In: Bone metastasis, edited by L. Weiss and H. A. Gilbert. Boston, USA, G. K. Hall Publishers, p. 1-10.