CASE HISTORY

The patient was admitted in May 1948 for biopsy of a pigmented papilloma of the hard palate, (s.48/790), which proved to be a malignant melanoma. It was treated with large doses of x-rays and radium. He was readmitted in October 1948 for a diathermy cauterization of the growth which was again biopsied (s.48/1522). No secondary deposits were present then after extensive examination. On 20.6.49 he had an x-ray examination of his chest which revealed multiple secondaries. He remained well until 10 days before admission when he had sudden onset of severe headaches and personality changes. On examination: he was confused; a small ulcer was seen on his hard palate; no abnormal signs were present on neurological examination and nothing abnormal was detected in the chest or abdomen. He became comatose, developed signs of pneumonia at both bases and died.

PATHOLOGY

Kidney 165mmx90mmx55mm. The specimen consists of the anterior half of the left kidney. Scattered throughout the kidney substance are spherical black deposits up to 1/2cm in diameter.