Rhabdomyoma of the parotid gland / by T. Mitchell Prudden.

  • Prudden, T. Mitchell.
Date:
[1883]
Catalogue details

Licence: Public Domain Mark

Credit: Rhabdomyoma of the parotid gland / by T. Mitchell Prudden. Source: Wellcome Collection.

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    some period of later life when the conditions favourable to its development might occur, the formation of such heterologous tumours would be no longer enigmatical, and their life history would be in conformity to the general laws of tissue growth and development. While the adoption of this hypothesis rendered comprehensible the occurrence of a large majority of the heterologous tumours, it found in the rhabdomyomata a most striking illustration, from the fact that they occurred—and occurred apparently exclusively—in connection with tlie genito-nrinary system—that is, in a series of organs whose development involves such unusually complex changes during their evolution as might well favour the occurrence of such slight irregularities in growth and mal¬ positions of minute clusters of ceils as tiiis hypothesis postulates. It is the purpose of this paper to record a new case of an lieterologous rhabdomyoma, which presents some unique and significant features both in structure and position. The writer is indebted for the epitomized clinical history of the case to Dr. E. T. Weed, House Surgeon to the Roosevelt Hospital, N. Y. C. B., a healthy lad, seven years of age, observed a swelling on the right side of the face, which was found to depend upon the existence of a small tumour situated near the angle of the jaw. It gradually increased in size, being painful, especially at night, and at last the swelling opened, discharging several pieces of bone. Healing then occurred, and tiie part remained in a quiescent condition for some time. Patient was admitted to hospital about twelve months after the first appearance of the tumour, with considerable swelling of the right lower half of face. During the ope¬ ration at the seat of lesion, dead bone was discovered on the outer surface of the ramus of the jaw. A moderately firm ovoidal tumour, about tlie size of a pigeon^s egg, was found occupying the position of the parotid gland, which was not seen as a separate structure. The dead bone and tumour being removed, a partial facial paralysis of the right side resulted, but the wound healed well, and the patient was discharged cured about eight weeks after the operation. The examination of the tumour by the writer gave the following results r The tumour, measuring about o.7 cm. by 3.8 cm. by 3.2 cm., is in general iobulated, and consists of two portions, firmly united, and merging without sharp demarcation into one another. About two-thirds of the tumour is quite firm in texture, surrounded by a thin, distinct capsule of connective tissue, and upon transverse section shows, irregularly scattered througli the mass, tiny spheroidal or occasionally elongated bodies, somewhat lighter in colour than the surrounding tissue, and sharply outlined against it. These bodies resemble greatly in appearance the glomeruli of the spleen. The remaining third of the tumour is distinctly Iobulated, soft, and has the general appearance of the parotid gland. The above-described spheroidal bodies are most abundant near the zone of junction of the harder and softer portions of tlie tumour, but they are present throughout the mass, and in general each thin section of one cm. square shows from eight to twelve of them. Upon microscopical examination, the smaller, softer portion of the
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