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A Case for Diagnosis (Melanoma of Skin?). Presented by Dr. Charles Wolf.
I. M., a man aged 51, has had for many years a flat pigmented lesion in the epigastric region, covering an area 3 by 4 cm. Pigmentation is lighter on the lower third and darker on the upper two thirds. In the latter section there are three raised rather firm nodules, the size of a split-pea, covered with a scale.
The Wassermann reaction of the blood was negative.
DISCUSSION
Dr. Maurice J. Costello: Therapy for malignant melanoma is discouraging as a rule, but wide surgical excision of the lesion with resection of lymph nodes would probably be the best approach.
Dr. David Bloom: Clinically, the lesion may be a benign pigmented nevus. In order definitely to ascertain the diagnosis a biopsy is necessary.
Dr. Louis Chargin: I am in favor of Dr. Bloom's suggestion. It is difficult to