Apart from the rare malignant melanomas occurring in blue nevi, primary cutaneous malignant melanoma arises in 1 of 3 ways, regardless of the presence or absence of a pre‐existing nevus. These three types have been designated: 1. Malignant melanoma, invasive, with adjacent intra‐epidermal component of Hutchinson's melanotic freckle type; 2. Malignant melanoma, invasive, with adjacent intra‐epidermal component of superficial spreading type; and 3. Malignant melanoma, invasive, without adjacent intra‐epidermal component. Occasionally, both clinically and histologically, there may be difficulty in deciding whether a malignant melanoma belongs to category 1 or 2, but, in the majority of cases, these 2 types can be quite readily distinguished. In addition to recording the histogenetic mode of development of a malignant melanoma, a histologic system of reporting is recommended which includes mitotic activity, levels of invasion, and vascular involvement. There are other parameters such as the cell type, pigmentation, lymphocytic infiltrates, evidence of spontaneous regression, associated nevi, and solar changes in the dermis, all of which are of unknown significance. The recording of these features, which are clearly of interest for research purposes, is left to individual discretion. It is emphasized that all the usual macroscopic descriptions and measurements should continue to be recorded.

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Portal vein embolisation (PVE) is used to increase the remnant liver volume before major liver resection for colorectal metastases. The resection rate after PVE is 60 -70%, mainly limited by disease progression. The effect of PVE on tumour growth rate has not been investigated. The objective of this study was to compare the growth characteristics of resected colorectal liver metastases in patients undergoing pre-operative PVE with those of matched controls who had not undergone PVE. There were 22 patients who had undergone preoperative PVE and 20 matched controls. Tumour growth rate was calculated by the change in tumour volume (CT/MRI volumetric assessment) from diagnosis to resection. Resected histological specimens were examined by two histopathologists independently for cell differentiation, percentage tumour cell necrosis and mitotic rate. Immunochemical staining with Ki67 was carried out using the MIB-1 monoclonal antibody and quantified using a Glasgow cell-counting graticule. The groups were comparable in demographics, stage of primary disease, volume of liver metastases at presentation and chemotherapy received. The tumour growth rate calculated from imaging was more rapid in the PVE group compared with that in controls (control: 0.05 ± 0.25 ml day À1 , PVE: 0.36 ± 0.68 ml day À1 , P ¼ 0.06). Histology showed no difference in the degree of differentiation, extent of necrosis or apoptosis between the two groups. However, mitotic rate was higher post PVE, as was the proliferation index Ki67 (P ¼ 0.04). This study has confirmed that tumour growth rate increased following PVE and that this is related to increased tumour cell division.

This review deals with difficulties of diagnosis in cutaneous malignant melanoma encountered by histopathologists of variable seniority and is based on referred material at The Royal Marsden Hospital over a 20-year period and on the experience of more than two-and-a-half thousand cases referred to The World Health Organisation Melanoma Unit which I reviewed when chairman of the Pathologists' Committee. Though there is reference to the differential diagnosis of primary and metastatic tumour, the main concern is with establishing the diagnosis of primary melanoma to the exclusion of all other lesions. An appendix on recommended diagnostic methods in cutaneous melanomas is included.

After a description of the morbid anatomical and histological appearances of equine melanotic disease, the author provides a critical review of the literature. The histogenesis is demonstrably via dermal melanocytic proliferation. By comparing the equine disease with spontaneously occurring and chemically induced dermal melanocytic tumours in the hamster, and with the wide range of behaviour pattern seen in the human blue naevus, also the subject of a review, he concludes that equine melanotic disease is best considered as a special manifestation of the blue naevus phenomenon.

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Two patients with synovial sarcomas of the pharynx and oesophagus respectively are reported and their clinical features are described. These tumours in the head and neck rarely metastasize to lymph nodes and their management is discussed.

SUMMARY Histological sections from 24 patients with malignant melanoma of the eyelid skin were studied and correlated with clinical follow-up for an average of 8*6 years. There was an average post-treatment follow-up of 7.4 years with a cure rate of 78% in the superficial spreading group. The average follow-up in the nodular melanoma group was 9*4 years with a cure rate of 75%. Nodular melanoma patients with the lesion in the lid margin have a worse prognosis than those with the lesion on the eyelid skin.Malignant melanoma of the eyelids, apart from the conjunctival surface, accounts for about 1% of all eyelid tumours' and slightly less than 7% of cutaneous malignant melanoma in the head and neck region.2 Because of its rarity descriptions have been based. on the study of small groups or isolated cases, and it has been difficult to establish a comprehensive and representative picture of the histology and behaviour of malignant melanoma in this situation. In the following account we describe the prognosis and histopathology in 24 patients followed up for between three and 33 years. Patients and methodsA total of 24 patients, for whom adequate follow-up information was available, were included in the series. Their ages ranged from 18 to 80 years, with a majority presenting in the 6th and 7th decades. Females (15) were affected slightly more commonly than males (9). More than half of the tumours were located on the eyelid margin, and a further half of these were unpigmented. The upper lid was affected in 16 patients the lower lid in eight. The distribution was equal in the medial and lateral areas of the eyelids. Although it was not possible to comment on the clinical presentation of the tumours because of the retrospective nature of the majority in this study, 25% of the patients were seen preoperatively by one (Fig. 1) were most likely to have a superficial spreading malignant melanoma than were patients presenting with a bulky or marginal lesion (Fig. 2), who were more likely to have a nodular melanoma.In our series 21 patients had surgery, two had irradiation, and one both treatments.The type of surgery varied with the size of the lesion. The margins of the excised specimens were histologically clear in 22 patients. In two patients in whom clearance was incomplete a second surgical procedure was performed with complete removal of