Surgical cases illustrating some facts of clinical interest / by Charles B. Nancrede.

  • Charles B. Nancrede
Date:
1893
Catalogue details

Licence: Public Domain Mark

Credit: Surgical cases illustrating some facts of clinical interest / by Charles B. Nancrede. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

    5/12 (page 3)
    paroxysms occurring at irregular intervals resulting from one secondary ddpot, not from numerous collections. This possi- bility is well known to many of my hearers, but not to the less experienced and the emphasis of this point may be of use to some. Case II.—Large Tumor of rapid growth, springing from the Internal Cutaneous Nerve.—Ida W., aged eighteen years, was admitted to the University hospital Febru- ary 6, 1893, with a negative family history, so far as carcinoma or tubercle was concerned. Her general health had been and was excellent. The present trouble commenced about eight months previous to her admission, within two or three da}^s of having her right arm bruised at the site of the tumor by a fall- ing window sash. The growth had steadily increased, more rapidly recently, until within two weeks its increased bulk had caused such lameness of the arm that she could hardly use it. Suspecting that the tumor lay beneath some of the large nerves, or had developed in connection with one of them, I carefully examined the large mass, which occupied the middle two-fourths of the inner surface of the arm, but could detect nothing posi- tive. A most careful dissection was therefore undertaken which showed that a bold cut down to the tumor would have divided the median nerve, which lay for four inches between the mass and the skin. The growth was readily isolated, except above' and below, when it was seen that the tumor embraced one of the nerves. By careful partial splitting of the growth, the nerve— the internal cutaneous—was finally dissected out and the tumor removed. A prompt and uneventful recovery ensued. What lessons can be learned from this case? One which I have had impressed upon me time and again, namely, that although a rapidly growing tumor in a young person following an injury is usually sarcomatous, yet it may be innocent, as in this instance. Professor Gibbes utterly failed, after repeated exami- nations, to discover-anything but fibro-fatty tissue. A second esson suggested by this case which all classes of surgeons migit profitably study—the experienced as well as the inex- perienced is, that it is always safest to consider those cases winch seem the least complicated, at first sight, to be exactly