Cancer has plagued mankind since antiquity. In Peru, paleopathologists examining mummies from the fourth century bc found diffuse metastases in the bones of the skull and extremities as well as rounded melanotic masses in the skin.³ The first accredited description of malignant melanoma appeared in the writings of Hippocrates (460-375 bc), followed by that of the Greek physician Rufus of Ephesus (60–120 ad). Over the centuries, many other physicians have described pigmented malignant lesions of the skin that presented with distant metastases. It was not, however, until the 1800s that significant gains were made in the description and treatment of human malignant melanoma.

In an unpublished paper presented to the Faculté de Médicine in Paris in 1806, Laennec discussed “la melanose,” describing its color as “melanotic.”⁴ The first description of the genetic basis of melanoma was offered by Norris in 1820.⁵ Carswell used the medical term “melanoma” in 1838 to describe pigmented malignant lesions of the skin.⁶ In 1858, Pemberton advocated and performed wide and deep radical excision for melanoma.⁷ This concept, which developed a full century before becoming the accepted surgical technique, also encouraged the removal of all implicated lymph nodes by groin dissection. In 1907, Handley again advocated en bloc excision of melanoma with wide margins, following the principle of dissection in continuity.⁸