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To the Editor:
—In the 20 year period from Jan. 1, 1932, to Dec. 31, 1951, of all the skin lesions that I excised and submitted for pathological examination positive evidence of carcinoma of the skin was found in 2,465 persons. The primary local nature of cancer of the skin in its early stage is often emphatically stated in both lay and medical communications. A review of the material mentioned above suggests the exigency of a less confident attitude in this respect. A brief summary based on these cases gives proof that, in a reasonably large number of cases, skin cancer, contrary to popular belief, is not a local phenomenon. Two or more anatomically widely separated areas in the same patient were found not infrequently to serve as independent cancer beds. No recognized manner of extension or metastasis from one cancer to the other or others was demonstrable. Malignant melanomas
Hollander L. SKIN CANCER. JAMA. 1952;150(10):1035. doi:10.1001/jama.1952.03680100077031