Miscellaneous Metastasizing Melanomas before the Year 1900

Melanoma was defined as a characteristically pigmented primary tumor whose use came in by 1838. Memorably, a Journal instituted in the following decade has provided materials for a series written up personally. In sum, the present paper describes an interesting group garnered from that Journal before 1900.


Introduction
The notable Merriam-Webster's Collegiate Dictionary [1] defined melanoma as a characteristically pigmented growth that was named in 1838. A decade later, a group of pathologists founded a Journal in London [2]. Now, the author noticed that Willis [3] tended to cite historical cases from it in his weighty work, "The Spread of Tumours in the Human Body." Therefore, it remained for me to personally follow suit. So far, my series has featured such organs as the pancreas [4], adrenal glands [5] and kidney [6]. Consequently, this last contribution focuses on miscellaneous metastases.

Historical Texts
The cranial nerves stand out as a group which Ogle [7] grasped thus: Moreover, a quantity of black deposit was found amidst the nervous fibres composing the seventh and ninth pairs of cranial nerves on each side, passing with them into their respective auditory and jugular openings, but only to a slight extent. Much of this deposit, in connexion with the nerves, was capable of being entirely removed by maceration in water for a few hours, and was obviously only connected with the delicate connective tissue uniting the various nerve filaments.
Close by was the attacked dura mater that Target [8] described as being near the original left orbit tumor. Next, Fagge [9] featured the prostate in passing. Also to be noted was White's [10] own words thus: "The growth had grown into the primary division of the portal vein to the right lobe, but not nearly enough to occlude it." Still on veins, there was the observation of Mackenzie [11] as follows: "There is seen here and there in the walls of the left pulmonary vein a firm, flattened, greyish-black or dirty-white nodule about the size of an almond." He also observed that both sides of the diaphragm were studded with cancer bodies. Furthermore, he spotted that "the wall of the gall-bladder, and common bile-duct have here and there clusters of black, firm, pedunculated, seal-like bodies, from the size of pin-point to that of split-peas." Not finished, he added the surfaces of the omenta as well as other organs thus: Prostate is exceeding hard, and on section is cram full of greyish-white solid bodies, about the size of a No. 5 shot.
Right testis, the only one examined, has blackish-grey spot the size of a split pea in its substance. Thyroid is hard and firm, and the right lobe considerably larger than the left. The surface is nodulated but smooth. On section it seems as if made up of greyish-white nodules, the size of small peas. Near the periphery of the right lobe they have a slaty-grey appearance. The upper part of the left lobe is occupied by a circumscribed, firm, fattylooking mass. The isthmus is reddish and apparently normal.
Incidentally, his acknowledgement went nicely as follows: "I am indebted to Professor Greenfield for making and staining the sections that so beautifully illustrate this case." The beautiful description of the omentum needs to be added by Legg [12] who wrote that it is folded up below the colon, but can be stretched out; it "is then seen to be made up of thousands of small whitish tumours the size of hempseeds; there are some few larger, the size of a pigeon's egg, but the greater number are small."

Discussion
It is remarkable that descriptions were written not in inches, let alone in centimetres, but with apt home-stead and farm-land materials respectively. They were almond, seal-like, pin-point, split-peas, No. 5 shot, hempseeds, and pigeon's egg. Nevertheless, I am persuaded that they satisfied the practical lesson of the great German Pathologist, Julius Cohnheim, [13] namely, that autopsies help in tracing Nature's foot-steps.

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 of the origin and progress of sarcomata in general.
To generalize here, similar data were not included in a recent historical review of Pigment Cell Biology, which was subtitled "THE EARLIEST STUDIES: PRE 1900 [15] Of course, the present paper is in line with what Kuphal and Bosserhoff [16] described as recent progress in understanding the pathology of malignant melanoma. Indeed, there is now progress along the lines of molecular and genetic diversity in the metastatic progress of melanoma [17].