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To the Editor:—
I should like to comment on the article by Dr. Leon Felderman entitled "Syphilis of the Larynx: Report of an Atypical Case" (Arch. Dermat. & Syph.44:667 [Oct.] 1941).The history and observations in this case, even with the negative serologic reactions and the apparent improvement under bismuth therapy, might lead to a presumptive diagnosis of syphilis of the larynx but would not rule out a carcinoma, as it is well known that tertiary lesions of the mucous membranes, notably of the tongue, frequently become malignant.It hardly seems likely that a competent histologist would have made a diagnosis of "squamous cell carcinoma, intermediate type III" without careful consideration and study of the cellular structure.The absence of carcinoma at necropsy can be accounted for as the result of the epithelitis, necrosis and ulceration that frequently follow the roentgen and radium treatment of laryngeal cancer.