Over the last 30 years, there have been approximately 49 case reports of tumors composed of both malignant epithelial and malignant melanocytic populations. Herein, we present four additional cases of combined tumors that consist of two phenotypically distinct but intermingled populations of malignant cells. Each tumor was composed of an invasive melanoma closely associated with either a basal cell carcinoma or a squamous cell carcinoma. We review all previous case reports in the English literature and attempt to clarify the terminology and summarize what is currently known about these unique tumors.

Tumors composed of malignant epithelial and melanocytic populations: a case series and review of the literature.

Tumors of surface epithelium.

Lentigines, nevi, and melanomas

We report a case of a very unusual combined and collision basosquamous melanocytic malignant tumor on the chest of an 84-year-old man. To our knowledge, this is the first case report describing this entity. We attempt to address the diagnostic challenge and the clinical and histological characteristics of these rare neoplasms with a review of the English literature to further categorize and summarize what has been previously reported about these extraordinary tumors.

Malignant melanoma within squamous cell carcinoma and basal cell carcinoma: is it a combined or collision tumor?--a case report and review of the literature.

Tumors of the surface epithelium

The simultaneous presence of two disparate neoplasms occurring in the same specimen has been well documented, albeit uncommonly. The juxtaposition of malignant melanoma and basal cell carcinoma (BCC) has been rarely reported in case reports, with most cases describing melanoma in situ and BCC. We present two cases of invasive melanoma (Clark level IV, no microscopic satellites present) intimately associated with BCC, and in areas distinction of the two lesions was difficult. Immunohistochemical studies delineated the two cell populations. In addition, one patient presented with multiple cutaneous metastases, all simulating blue nevi. The metastases occurred in the same anatomical region as the primary tumor, and histologically consisted of pigmented dendritic melanocytes and melanophages in the superficial and mid-dermis and arranged in a blue nevus-like lesion. Histologic clues suggesting the possibility of a metastatic melanoma included a sparse lymphocytic infiltrate, the presence of an epithelioid component and atypia of the dendritic melanocytes. However, without appropriate clinical history, the lesions could be overlooked as ordinary blue nevus. Collision tumors containing invasive melanoma and BCC are rare and this is the first report of a collision tumor with blue nevus-like metastasis. Awareness of this phenomenon and pattern of metastasis, together with the clinical findings will aid in the correct classification of these lesions.

Primary invasive melanoma and basal cell carcinoma (collision tumor) with blue nevus‐like cutaneous metastases

This paper is intended to serve as an introduction both to the first session and to the Discussion Meeting as a whole. I begin by distinguishing natural human languages, in relation to their apparent species-specificity, from non-natural languages and from non-human languages. I then explain the technical terms 'language system', 'grammar', 'lexicon', 'competence' and 'performance'. Languages, as we know them, are manifest in two mediums: in the phonic medium when spoken; in the graphic medium when written. Although there are good reasons for saying that speech is primary in relation to writing, in any discussion of the psychological mechanisms of language, it is important to maintain a distinction between language and medium, as follows. (1) It is possible that the integration of syntax and phonology, though based on a species-specific biological endowment for the acquisition of language and for vocalization, is a product of the normal environmental conditions in which languages are acquired and should not be ascribed to what Chomsky identifies as universal grammar. (2) Spoken utterances have a linear, time-related, structure. Sentences, as medium-independent units, do not. What, then, are the factors that determine the linearization of sentences so that, in particular contexts of utterance, one order of words and phrases, rather than another, is adopted? Are the same factors responsible for the fixation of word-order in those languages in which the order of words and phrases has a grammatical function? More generally, do such psychological factors, including the requirements of on-line processing, have an influence upon the historical development of language systems? (3) Is the language system, including the lexicon, stored in the brain in a medium-independent format, so that it can be accessed equally well in both speech and writing and without either of them influencing the other?

http://rstb.royalsocietypublishing.org/content/royptb/295/1077/215.full.pdf

Language and Speech [and Discussion]

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Primary invasive melanoma and basal cell carcinoma (collision tumor) with blue nevus‐like cutaneous metastases

Language and Speech [and Discussion]