DURING the past sixteen years more than three thousand cancers have been removed by means of the microscopically controlled excisions which characterize the method which we have termed "chemosurgery."1 A striking observation repeatedly made during the course of these excisions was that many external cancers exhibited irregular outgrowths which had not been detected by clinical visualization and palpation.
In some cases these "silent" extensions were due to a peculiar affinity of the cancer for some specific tissue structure which it would follow selectively for unexpectedly great distances. Some structures for which certain cancers showed particular affinity were the following: (1) dermis, (2) fascial planes, (3) periosteum, (4) perichondrium, (5) embryologic fusion planes, (6) nerve sheaths, (7) lymphatic vessels, and (8) blood vessels. In other cases no specific affinities were observed, but nevertheless irregular outgrowths were present, apparently as a result of the countless local variations in
MOHS FE, LATHROP TG. MODES OF SPREAD OF CANCER OF SKIN. AMA Arch Derm Syphilol. 1952;66(4):427–439. doi:10.1001/archderm.1952.01530290003001
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