By Hilliard F. Seigler (auth.), H. F. Seigler (eds.)
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Just as Smith and Stehlin's eight patients provided support for the regression hypothesis, the 31, for whom their scrutiny failed to uncover pigmented skin lesions, leave open the issue of tumor origin. Finally, the most general starting assumption is that both mechanisms may work, and until there exists evidence that one is unlikely the safest assumption is the most general. All these arguments are of lesser importance, since they affect only how we conceptualize melanoma. The important and established fact about occult melanoma is that some of these patients who have melanoma in regional lymph nodes will achieve a long survival after lymph node resection.
Electron 35 microscopy of at least one case has demonstrated dense core granules in the central cells and premelanosomes and melanosomes in the peripheral cells . Melanoma of unknown primary site In clinical practice and in reported series of melanoma patients, there are some who have metastatic melanoma without an obvious primary site . The prevalence of these is 4 % among all melanoma patients, and they fall into two roughly equally numbered categories: those with tumors in a single regional lymph node group, and those who have either regional lymph nodes and regional cutaneous and subcutaneous tumor nodules or who have distant or disseminated tumor.
Glans glans & meatus meatus meatus ? prepuce glans glans prepuce glans & shaft glans glans glans glans glans glans ? glans glans ? glans glans, meatus prepuce glans glans glans Nodes + ? + + + + + + + + + ? + + ? ? + ? ? + ? ? + +* 44 Table 1 continued. Author Reference Patient age Baruah Shanik Tallerman 49 50 37 70 51 63 56 Kherzi 17 72 42 * Presenting symptoms Site glans ulcer glans, prepuce swollen, tender penis pain, swelling glans & corpora phimosis, difficulty voiding prepuce swelling, change in color glans prepuce lesion Nodes + + + ?
Clinical Management of Melanoma by Hilliard F. Seigler (auth.), H. F. Seigler (eds.)