Dr. Robert Edward Scully

Architect of Modern Classification of Ovarian Tumors

Robert E. Scully, MD, a pathologist at the Massachusetts General Hospital (MGH) for 55 years and Emeritus Professor of Pathology at Harvard Medical School, died on October 30th after a short illness. Dr. Scully was a legendary figure in diagnostic pathology because of his many contributions to the field. Throughout his career he was a mainstay of the pathology faculty at the MGH and was known throughout the Harvard Medical School community and around the world for his diagnostic prowess. Although practicing general pathology throughout most of his career, he took a special interest in gynecologic and testicular pathology.

Dr. Scully’s work habits were prodigious and his output in interpreting difficult cases and preparing manuscripts and reviews in his areas of interest were remarkable. A book published in 1958 on tumors of the ovary with Dr. Jack McLean Morris, then an MGH gynecologist, established his early reputation as an authority on ovarian tumors. Shortly thereafter, he was selected co-editor of the World Health Organization (WHO) classification of ovarian tumors. With a group of other international authorities Dr. Scully devised a classification that was much more logical and organized than what had hitherto existed. This has had tremendous benefits for patient care because of the prognostic importance of the many different types of ovarian neoplasms. Dr. Scully’s activities rapidly made him the source for second opinions on difficult pathologic interpretations throughout the field of gynecologic pathology; the many cases he saw, and his astute eye, enabled him to recognize unique patterns that had not been appreciated by others. At least ten new categories of ovarian neoplasia were established based on his observations. In the late 1990s Dr. Scully led the group that classified all female genital tract tumors for the WHO. With minor modifications, this remains the current scheme for pathologic subclassification of female genital tract neoplasms worldwide.

Dr. Scully was an important member of the MGH team that in the early 1970s established a relationship between in utero exposure to diethylstilbestrol (DES) and subsequent unusual cervical and vaginal tumors in young women. Dr. Scully noticed an unusual spike in frequency of clear cell carcinoma of the vagina and cervix in late teenaged females (hitherto exceptionally rare). As this was made known to clinicians, the mother of one patient questioned a possible association with something she had taken while pregnant; this fortuitous remark led to the establishment of this now famous association. A registry for these tumors was subsequently established, and for many years Dr. Scully was the pathologist, and this experience resulted in many papers on this topic over the years.

In the 1970s Dr. Scully was asked by the Armed Forces Institute of Pathology to prepare a book on the ovary for the Atlas of Tumor Pathology, a well-known series of books published under the auspices of the American Registry of Pathology. The book was published in 1979 and distilled Dr. Scully’s vast knowledge of ovarian tumors and the many issues in differential diagnosis that they pose for the pathologist. In addition, because of Dr. Scully’s awareness of the crucial the impact of the pathologic interpretation on treatment and prognosis, that work contains significant coverage of clinical aspects of these diseases. He always cautioned about making pathologic diagnoses without complete awareness of the clinical background that can have bearing on the microscopic diagnosis. He wrote an expanded and revised version of the book that was published in 1998.

Dr. Scully was Editor for 27 years of the well-known Case Records of the MGH, published each week in the New England Journal of Medicine (NEJM). This obligation required the presentation each week of the complex clinical record and clinical and pathological discussion of an unusual medical or surgical case (Clinicopathological Conference, or CPC), which Dr. Scully then edited for publication. In this activity Dr. Scully’s immense knowledge of medicine and outstanding writing and editorial skills were brought to bear, leading to a remarkably high standard of the published Case Records, which became one of the most widely read medical publications in the world.

Many of the current leaders in the field of gynecologic pathology trained with, or spent time with Dr. Scully as visiting fellows, and his influence has accordingly been felt world-wide. He traveled extensively throughout the world giving carefully prepared lectures, being aware of how important it was to teach not only locally at his own hospital and medical school but as widely as possible. His travels brought him in contact with countless pathologists and clinicians throughout the world, all of whom developed great affection for him because of his personal qualities, gentle demeanor, humility, kindness and respect to all. He was always more than happy to share credit with others, and indeed often assisted with papers that ultimately did not bear his name, as long as he felt that knowledge and hopefully patient care were being enhanced as a result.

Dr. Scully attained the rank of Professor of Pathology at Harvard Medical School in 1971. He was the founding President of the International Society of Gynecological Pathologists, in the 1970s, and served for six years in that role. Dr. Scully received many honors throughout his career. Some that he most treasured were: an honorary degree from his alma mater, the College of the Holy Cross; the Fred W. Stewart Award of Memorial Sloan-Kettering Cancer Center; the Distinguished Pathologist Award of the United States-Canadian Academy of Pathology; and an Honorary Fellowship of the Royal College of Pathologists. A Harvard Medical School Professorship in his name was endowed near the end of his career, funded by donations from his many colleagues and admirers. In the mid 1990s, after the death of his brother, Dr. Scully curtailed his work significantly, initially working half days; ultimately after 2001, he stopped coming to the laboratory. Even in his later retirement years, however, he had a microscope at home and would be shown cases of particular interest by current MGH faculty. He also continued to work on reviews and chapters, most recently for a book on history of the MGH Pathology Department.

Robert E. Scully was born in Pittsfield, Massachusetts on August 31, 1921. Dr. Scully graduated magna cum laude from the College of the Holy Cross in Worcester, Massachusetts in 1941 and from Harvard Medical School in 1944. Dr. Scully trained in pathology at the then Peter Bent Brigham Hospital and Children’s Hospital under Dr. S. Burt Wolbach and Dr. Sydney Farber. He then spent a year as resident at the Free Hospital for Women in Brookline and Boston Lying-In Hospital under the eminent gynecologic pathologist, Dr. Arthur T. Hertig. That was followed by a year at Pondville State Cancer Hospital in Norfolk. He then spent a year as instructor at Harvard Medical School before being recruited by Dr. Tracy B. Mallory to the Massachusetts General Hospital. His early tenure at the hospital was interrupted by two years of service in the US Army during the Korean conflict from the fall of 1952 to the summer of 1954. He rejoined the MGH faculty in 1954.

Dr. Scully was beloved by all who had the good fortune to come in contact with him and with his many contributions has left a rich legacy that has benefited and will benefit the care of countless persons in years past and years to come.

Dr. Scully is predeceased by his brother George B. Scully and George’s wife Cecile, and his nephew George B. Scully Jr. He is survived by nieces Elizabeth R. Scully of Jamaica Plain, MA and Paula S. Raines of Portland, OR; his nephew Robert E. Scully and his wife Elizabeth of Charlton, MA; his grandnieces Elizabeth A. Raines of Portland, OR and Laura E. Scully of Boston, MA; and his grandnephews Christopher R. Raines of Madison, WI, Thomas B. Raines of New Orleans, LA, and Cameron J. Scully of Salem, MA.

In lieu of flowers gifts may be made to the MGH Dr. Robert Scully Lecture Fund, Mass General Development Office, 165 Cambridge Street, Suite 600, Boston, MA 02114, Attention Bob O'Brien or to The College of the Holy Cross, 1 College St., Worcester, MA 01610, Attention Development Office.