A Case of Melano-Sarcoma of 
the Nose cured by Gal- 
vano-Cauterization. 
BY 
R. P. LINCOLN, M. D., 
NEW YORK. 
REPRINTED FROM 
Ebe Neto ¥orfc fBebical .journal 
for October 10, 1885. Reprinted from the New York Medical Journal 
for October 10, 1885. 
A CASE OF 
MELANO-SARCOMA OF THE NOSE 
CURED BY GALVANO-CAUTERIZATION.* 
By R. P. LINCOLN, M. D., 
NEW YORK. 
In November, 1884, Mrs. L. presented herself for con- 
sultation, and supplied the following history : 
In August, 1882, she first noticed an obstruction to free 
respiration in the right nostril, and about the same time was 
annoyed by a continual muco-purulent, blood-stained discharge 
from the same nostril. There was also matter of a similar 
appearance which was expectorated, and which evidently came 
from the posterior nares. 
Iler general health at this time was good, and there was 
little or no pain. 
It was not till the following winter that this nostril became 
completely occluded, when operative interference was decided 
upon. 
Dr. D. Hayes Agnew, of Philadelphia, removed the growth 
April 2, 1883. After a microscopic examination, he announced 
its character as " cancerous." After a period of about two 
months a repetition of the former symptoms manifested them- 
selves; these continued to increase until November following, 
when Dr. Agnew repeated his tirst operation. 
A few months of uncertainty succeeded the second opera- 
* Read before the American Laryngological Association, June 25, 
1885. 2 
MELANO-SARCOMA OF THE NOSE. 
tion, but frequently recurring haemorrhages and renewed diffi- 
culty in breathing gave assurance of a recurrence of the tumor 
until February, 1884, when the growth seemed to increase very 
rapidly. At this time the patient placed herself under the care 
of a physician in Rome, in this State, a man of much repute 
among the people, who used, in the words of the patient, 
" plasters and pastes " for about two months, when he confessed 
bis inability to remove the trouble. Notwithstanding this treat- 
ment, the tumor continued to grow. 
On examining the patient, I found the right side of the nose, 
extending well up to the inner canthus of the eye of the corre- 
sponding side, enlarged, the fullness amounting to about four 
times the size of the left side of the nose. 
The lower half of its ala was wanting, the remaining border 
being puckered, somewhat contracted, and of a purple color, 
which gradually faded until the integument was of normal ap- 
pearance half way up this side of the nose. There protruded 
from this nostril, about half an inch, a dark-colored, fleshy mass 
completely filling it; this was attached to the outer margin of 
the nostril as well as to its floor. A plum-colored discharge 
was constantly flowing from the nostril, and the lightest touch 
of the mass with a probe was followed by dark grumous blood. 
A further careful exploration showed the tumor to grow from 
the lower and middle turbinated bones, and from the floor of 
the nostril for a distance of two inches and a half. The septum 
was free. 
A rhinoscopic examination disclosed the tumor protruding 
into the post-nasal cavity and occupying about half of it. I 
proposed a removal of the growth with the galvano-cautery 6cra- 
seur and a subsequent cauterization of points of attachments as 
offering the best chance of relief. 
November 18, 1884, the patient submitted to operation, Dr. 
Delavan and Dr. Goodwillie being present and kindly giving 
their assistance. The patient being etherized, I passed the 
platinum-wire loop of the galvano-cautery ecraseur about the 
tumor at its attachments and thus separated it. 
Immediately afterward the seat of the growth was thor- 
oughly cauterized. The loss of blood was inconsiderable. For MELANO-SARCOMA OF THE NOSE. 
3 
a week after the operation a solution of bicarbonate of sodium 
and carbolic acid was injected into the nostril many times a 
day; after this an ointment containing two grains of iodoform 
to an ounce of vaseline was applied to the healing surface 
three times a day. 
Two weeks after the operation the patient wrns permitted to 
go to her home in Pennsylvania, with no diseased point dis- 
coverable and with perfectly free respiration through the nostril. 
May 27, 1885.-The patient returned at intervals of one or 
two months, the last time on this date, for observation. No 
further treatment has been necessary, as the parts are perfectly 
healthy. The integument, formerly discolored, has assumed a 
normal appearance. The remaining deformity is hardly notice- 
able, far less than the most hopeful would have expected. 
T present herewith a specimen of the tumor mounted 
for microscopic examination, together with a report of the 
microscopic appearance, both of which were made by my 
friend Dr. Frank Ferguson. 
His report I quote : 
" The cut surface is dark, with small areas of dark gray and 
tiesh-colored tissue. Under the microscope the portion of the 
tumor which is flesh-colored is composed of round and ovoid 
cells of medium size. The cells are close to each other and dis- 
tinctly nucleated. The darker portions of the tumor are haem- 
orrhages. The areas of dark gray are composed of large flat 
cells deeply pigmented. The cells are supported by a stroma of 
fibrillated and granular material. There are numerous large 
vessels seen throughout the tumor, some of them with thick 
walls; also a few gland-ducts, probably the remains of glands 
belonging to the tissue in which the growth originated. 
"There are numerous haemorrhages throughout the entire 
tumor, in some places large, in other places punctate. Prog- 
nosis grave." 
Nate.-Information received from the patient October 1st showed 
that there were no indications of a return of the disease.