The White House physician saw a tumor and immediately thought it was cancer, the reason for urgent surgery.



To explain his absence from the White House, President Grover Cleveland announced that he was taking his friend Elias C. Benedict's yacht, the Oneida, on a four-day fishing trip from New York Harbor to his summer home in Cape Cod over the Fourth of July holiday.



Under cover of darkness early on June 30, 1893, Cleveland and six physicians climbed aboard the yacht, where they decided to do the risky surgery. On July 1, the president and the doctors went below to the yacht's parlor, which had been equipped with sterilized instruments and nitrous oxide and ether for anesthesia.



Cleveland instructed the surgeons to preserve his trademark mustache so the public would not suspect surgery had been performed. In a 90-minute operation, done using a special cheek retractor, doctors removed the tumor, along with five teeth and part of Cleveland's upper left palate and jawbone. As the procedure was done entirely within the mouth, there were no external facial scars.



The procedure was completed without complications, and the yacht sailed on, reaching the president's summer home on July 5.



In mid-July, a vulcanized rubber prosthetic was applied to fill the gap left in the president's mouth. Cleveland rapidly regained his usual speaking voice. As far as the press and public knew, the president had merely suffered a toothache. His mustache was unchanged.



Congress was unaware of the surgery during a special summer session called by the president to address the financial crisis.



But the secret was not to last. On Aug. 29, 1893, the Philadelphia Press reported the story of the surgery - which the president firmly denied. The journalist who broke the story wound up in disgrace until one of the doctors came forward years after Cleveland's death in 1908 of a heart attack, and confirmed the story.



The surgery - made even more challenging by the fact it was done on a moving yacht - yielded a gelatinous mass, thought to be a malignant sarcoma, though different pathologic diagnoses were reported. Finally, in 1980, 87 years after the surgery, the tissue was reexamined, and found to be verruccous carcinoma, a less virulent cancer than the White House physician had feared, a finding reported in the Journal of the American Medical Association. You can go see that tumor for yourself, preserved in a glass bottle of formalin, at the College of Physicians' Mutter Museum in Philadelphia.