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16 Metastatic melanoma

16 Pathology specimen. Metastatic melanoma
Age/sex: 38-year-old female
Size: 26.3 x 14.2 x 5.3 cm
The specimen shows numerous, more or less round nodules (N), each an independent focus of melanoma growth following spread in the blood from the cancer’s site of origin in the skin (metastasis). Some melanomas are gray or black in appearance, reflecting their ability to manufacture melanin, a pigment which is present in normal skin cells (melanocytes) from which the cancers arise. Others, however, lose this ability and appear tan-colored or white, as in this specimen.


Metastatic melanoma

Not every important medical observation has been made by famous clinicians or investigators. An example of this is provided Dr. William Norris, a general practitioner from Stourbridge, England, who published his findings about melanoma in 1820. In his post-mortem examination of a 59-year-old man , Norris noted the common finding of widespread metastasis in the disease:

“On opening the abdomen I found numerous tubera of various sizes. To the eye of the morbid anatomist it was interesting to behold the tumors scattered in the utmost profusion in every direction. … The lungs were on both sides thickly mottled in large and smaller masses throughout the greater part of their texture.”

Although such spread can still be seen today, excision of “atypical” moles before a melanoma has had the chance to spread to other parts of the body has resulted in a much better overall outlook for the disease than in patients of Norris’s time.

Below: An in-situ skin melanoma. Notice the irregular outline and uneven pigmentation.

Source: DermNet. Superficial spreading melanoma.

Skin lesion

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