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In a group of 440 autopsies performed at the State Institute for the Study of Malignant Disease, at Buffalo, on patients dying from a malignant lesion, a series of 186 cases were found in which the primary growth arose from squamous epithelium. These cases were divided into two groups, those in which distant metastases occurred and those which remained localized, the involvement of regional lymph nodes or invasion of surrounding structures by direct extension being considered a localized lesion. A search of the literature showed that distant metastasis from squamous-cell carcinoma is relatively infrequent. Price, in a series of 158 consecutive autopsies in cases of squamous-cell carcinoma of various parts of the body, found metastases in 19, the commonest sites of secondary involvement being the lungs, liver, and kidneys. He quotes other observers, as Naegeli, who in 190 cases of primary carcinoma of the skin and aural mucosa found no metastases in internal organs, and Crile, who found secondary cancer foci in distant organs and tissues in less than 1 per cent of a series of 4500 cases of carcinoma of the head and neck, all of squamous epithelial origin. He also mentions Halberstaedter and Simons, who found metastases in 19.3 per cent of the infiltrating types of skin tumor when first seen. This was in a series of 556 cases.

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The specific activity of calcium in the blood following intravenous injection of 47Ca was studied in six normal subjects, three patients with osteoporosis and eight patients with secondary cancer of bone. Measurements were made from 2 min after injection to 8 or 10 days later. When the results were plotted on log-log graph paper, they followed 2 or 3 straight lines (i.e. power functions). the pattern of which was characteristic of the bone condition concerned. Many other data can be similarly represented more simply by power functions than by exponentials. It is suggested that although this finding is empirical, it does nevertheless give additional meaning to the results obtained.

Hepatic dearterialization was performed in a group of twenty-seven patients. The amount of tumor tissue within the liver was evaluating according to a three stage scale. Five of the patients had stage 1 disease, eleven had stage 2 disease, and eleven had stage 3 disease. The postoperative mortality as well as the survival was related to the stage of the disease. The mean survival for those patients surviving postoperatively months was 4.5 months: nine months for those with stage 1 disease, 4.1 months for those with stage 2 disease, and 3.2 months for those with stage 3 disease. The present study group is a selected one for some patients with a good postoperative course and in whom dearterialization was successful were later the recipients of other types of hepatic tumor control such as liver resection or infusion of oncolytic drugs. These patients are excluded from the present study group. In the study reported herein no effect with regard to survival was obtained with the use of hepatic dearterialization. There is, however, clear evidence that dearterialization leads to necrosis of the majority of tumor cells. Hepatic dearterialization, as a sole procedure, is not enough to control tumor growth within the liver. It should be combined with other methods. Our present policy is to start with dearterialization and then perfuse the liver with 5-fluorouracil via the portal route for at least three months.

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To the Editor.— Alopecia neoplastica was discussed in theArchivesby Nelson (105:120, 1972). The following summary from my article about breast cancer may be of interest to your readers.1 Metastases from breast cancers causing sclero-atrophic alopecia are rare but they show a family likeness: on the one hand, spherical shape, complete loss of hair, changes in the pilo-sebaceous orifices, depressions and discrete nodules; on the other hand, infiltration and adherence to the underlying tissues with an inflammatory look recalling lupus erythematodes. These characteristics, although transitory (usually a few months), seem to us to be enough, in a woman, to support the diagnosis of metastases and their mammary origin. These metastases usually change more or less rapidly in the direction of the two other types of secondary cancer, inflammatory, and nodular. From the histo-pathological point of view, it can be difficult formally to assert a mammary origin confronted with