alexa Transpulmonary Passage of Cancer Cells from the Orbit to the Liver

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Transpulmonary Passage of Cancer Cells from the Orbit to the Liver

Curiosity was shown by our medical forbears in the field of spread of eye melanoma to the liver. Thus, consider that, by 1855, when he presented a case of “Melanotic cancer in various organs,” Sanderson [1] lamented that “The orbits were inadvertently not examined.” Likewise, by 1898, Calvert and Pigg [2] reported a case of melanoma involving numerous organs but had to admit that the excised right eye “was not examined microscopically.” Similarly, when White [3] reported a case and cited others, he stressed that “Probably all these three cases were primary, but they would be much more complete if it could be definitely stated in all of them that the orbit was examined and that the body was carefully searched for moles. There is no mention of any such examination in either Frerichs’ or Block’s, neither did Wickham Legg examine the orbit.” Orbit search was not only reported upon but also theorized upon by Moore [4] as follows: The second example, illustrating the relation of descent between a primary new growth and secondary new growths is afforded by a man aged forty-seven, who was first under my care as an out-patient, and afterwards in St. Bartholomew’s Hospital, to which he was admitted on Aug 25th, 1888. He died on Sept 22nd in the same year. Three years and five months before his admission his right eye had been removed by operation for a new growth in it, which proved on examination to be a melanotic sarcoma, growing from the choroid membrane, and containing dark pigmented connective-tissue cells of the kind normally abundant in the capillary part of the membrane. In August, 1888, when I saw him first, he had a greatly enlarged liver. The socket of his right eye was empty and showed no sign of disease. His left eye was natural. After death the enlargement of his liver was proved to be due to its infiltration by numerous masses of new growth mainly consisting of dark pigmented connective-tissue cells, precisely resembling those of the capillary part of the choroid membrane, and wholly unlike any normal cellular structure of the liver. Some of the abdominal lymphatics and the kidneys contained similar masses of pigmented sarcoma. Neither kidneys nor lymphatics normally contain any such pigmented connective tissue (

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