Thoracic resection for tumors growing from the bony wall of the chest / F.W. Parham.

  • Parham, Frederick W.
Date:
1899
Catalogue details

Licence: Public Domain Mark

Credit: Thoracic resection for tumors growing from the bony wall of the chest / F.W. Parham. Source: Wellcome Collection.

Provider: This material has been provided by the Francis A. Countway Library of Medicine, through the Medical Heritage Library. The original may be consulted at the Francis A. Countway Library of Medicine, Harvard Medical School.

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    celled sarcoma, while the nodules found in the lungs showed distinct sarcomatous elements, but of round-cells. It is of j)atliol()gical interest to note how secondary growths differ from tlie parent tumor. Case XXIX. Tietze's third case, 1889, sarcoma (Reported from Fischer's suro;ical clinic in Breslau, Deutsch. Zeitsch. f. Cli'w., 1891, Band xxxii. p. 424). A. G., aged twenty-eight years, wife of a harness-maker. Family history good. Menstruated at sixteen. At the age of nineteen, while dancing, received a blow on the left breast, and had pain for some days. A hard lump developed on the outer side of the left mamma, about the size of a walnut. At twenty-two she married, the lump being ])resent, but causing no inconvenience. During her first pregnancy, in the second year of her married life, the lump became larger. She was twice pregnant afterward. Tlie tumor became larger during lactation. During last pregnancy (the fourth), the tumor attained the size of a man's fist, and increased rapidly in size during lactation with marked pain, which necessitated weaning. She presented herself at the surgical clinic August 12,1889. Examination : No enlarged axillary glands. Dimensions of tumor: length, 11 cm.; breadth, 15 cm.; height, 12 cm. Operation: Circular incision extending toward axilla, exposure of capsule, which was easily separated from the flaps. Tumor seemed to originate from the chest wall, extontling toward the sternum and thence to the cartilage of the fifth rib. The adjacent ribs were separated so that the tumor seemed to be surrounded by a bony ring. The fifth rib being cut and the tumor being lifted, tiiere were found both pericardial and pleural adhesions. The pericardial adhesions offered nodilli- culty, l)ut in separating the pleura from the tumor this mem- brane was torn in several ])laos, and iluring the manipulation the severed rib broke, jn'rinilting the entire nunoval of the tumor. The larger purlion of the pericardium was now to
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