Primary melanoma of the gallbladder with cervical metastasis and fourteen and a half year survival.First histologically proved case

HE gallbladder is one of the rarest of the T extracutaneous sites of origin of malignant melanomas.There have been only three alleged cases reported in the literature.Even in these three, the conclusion that the gallbladder was the primary site was inferred entirely on the basis of the clinical and gross morphological examination, rather than from histological documen tation.As a result of the work of Allen1 and Allen and Spitz,2 who ascribed meaning to the presence or absence of overlying junctional changes, it became a relatively simple matter to determine, unequivocally, whether or not a melanocarcinoma was primary or metastatic at a given site.With the application of this criterion, histological authentication of the origin of the melanocarcinoma in the gallbladder was made possible for the first time, in the case herewith described. CASE HISTORYT. R., a 45-year-old fireman, was admitted to the Albany Hospital on January 16, 1941, with a history of a mass in his neck for two years.He had felt well and strong and had no other complaints.Family and past histories were negative.Physical examination revealed a well-developed, well-nourished man in no apparent acute distress or discomfort.In the right cervical region, over the anterior border of the upper third of the sternocleidomastoid muscle, was a freely movable mass, 5x10 cm. in diameter, that was thought to be a sebaceous cyst.Palpation of the abdomen revealed slight tenderness in the right upper quadrant.On the day of admission, the cervical mass was excised, using sodium pentothal anesthesia, by Tiffany Lawyer, Sr.T h e patient was discharged the following