The cause of malignant tumors generally, and of the pigmentous sarcoma of the choroid especially, is a mystery to us. It is impossible to find one general cause for all of them. The reason, in my opinion, is that there are different causes in existence for different forms of the disease.
In 1882, I observed and published reports of two cases in which the monolateral congenital pigmentation formed the predisposition to the development of a melanotic sarcoma of the choroid.
The color of the iris in the healthy eye was grayish green; in the other dark brown, and the sclerotica of the dark eye contained around the cornea some large dark violent spots which were congenital according to the decided assertions of the patient.
In the one case, the eyeball was enucleated at once and showed a pigmentous sarcoma of the choroid. The melanoid spots of the sclerotica extended over
HIRSCHBERG J. ETIOLOGY OF PIGMENTOUS SARCOMA OF THE CHOROID. JAMA. 1905;XLV(22):1617–1618. doi:10.1001/jama.1905.52510220003001a
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