HX15 The first Hunter of melanoma: a forgotten surgical milestone in dermatology

Abstract Dr John Hunter (1728–1793), a Scottish surgeon and anatomist, is regarded as a pioneering figure in the history of melanoma surgery. He is credited with the first recorded surgical removal of a melanoma in the Western medical literature. In 1787, while working at St George’s Hospital Medical School in London, Hunter operated on a 35-year-old man with a recurrent tumour in the jaw. The tumour, described as ‘soft and black’, was labelled by Hunter as a ‘cancerous fungous excrescence’. Although Hunter did not recognize the lesion as melanoma – as the disease had not yet been identified as a distinct entity – he successfully excised it, marking a significant moment in the history of surgical oncology. This surgical intervention demonstrated his skill and forward-thinking approach to cancer treatment at a time when medical understanding was still limited. Hunter preserved the excised tumour as part of his extensive pathological collection. In 1968, the tumour was retrospectively diagnosed as melanoma, further highlighting the historical significance of Hunter’s work. Today, the preserved specimen remains in the Hunterian Museum at Lincolns Inn Fields, London, serving as an enduring testament to his contributions to medical science. Hunter’s case laid the groundwork for future advancements in the understanding and treatment of melanoma, even though the pathology of the disease was not fully understood during his time. Hunter’s meticulous approach to specimen preservation, his documentation of clinical cases, and his innovative surgical methods significantly advanced the fields of pathology and surgical oncology. His work demonstrated an early recognition of the importance of surgical excision in melanoma treatment, long before the biological nature of melanoma was clarified. Although Hunter did not fully comprehend melanoma as we understand it today, his contributions have cemented his place in history as the first known melanoma surgeon, leaving a lasting legacy in modern surgical practice and pathology.