Malignant newgrowth in childhood. I. Malignant disease of the uterus, ovary, and vagina in children / by William A. Edwards.

  • Edwards, William A. (William Aloysius), 1860-1933.
Date:
1909
Catalogue details

Licence: In copyright

Credit: Malignant newgrowth in childhood. I. Malignant disease of the uterus, ovary, and vagina in children / by William A. Edwards. 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.

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    fibroma, fibromyoma, myoma, sarcoma, or carcinoma. All except I the last two are very rare in children, and these even are of very i infrequent occurrence. Sarcoma of the vagina, however, is more : frequent in children than in adults; in one of the series in the litera- ture, that of Starfinger, of 26 cases, 24 were in children under five years of age; indeed, 10 were under one year of age. Malignant • disease of the vulva and vagina constitutes but 1 per cent, of all ! malignant disease of the genital tract at all ages. The growths : may apparently be congenital or appear early in life, before the fifth ^ year, many, in fact, before the first year. They may develop from the walls of Gartner’s canals or from an obliterated Muller’s duct. Primary sarcoma of the vagina is the most frequent malignant growth i in childhood and is a specialized form of malignant disease which may affect any or all of the connective tissues which are involved lin the complicated developmental processes associated with the formation of cloaca. Sarcoma of the vagina in childhood is usually microscopically the characteristic structure of racemose sarcomas. ! Striated muscle fibers are sometimes seen in the primary tumor, the secondary growths, and in the metastases, fibers which Piquand^® says resemble the striated muscle found in a three-months’ 1 foetus. The sarcoma usually grows in the connective tissue of the I pelvic organs, and may extend in all directions, into the uterus, ’vagina, bladder, and urethra. In some cases it may remain cir— (cumscribed in the vagina; its usual clinical form, however, is that I of a polyp, either vaginal or uterine, often both. In children vaginal sarcoma shows very distinctly this tendency I to become pedunculated, polypoid, and multiple. It pursues a • comparatively slow growth and ulcerates very slowly, if at all; ' the lymphatic glands are affected, if at all, late in the case, and in • consequence it dissiminates very slowly. The growth may be so : slow that Herndon,^® who has written a most valuable article on the ] pathology of the reproductive organs, thinks that the tumors that 'Were not observed until the sixth and fifteenth years, respectively, : are probably congenital, but do not show active growth until this i later period. There is usually little trouble in making the diagnosis, but un- ! fortunately the general practitioner is apt to look upon the polyps ■ as benign growths, and the diagnosis is then not made until it is too ' late to remove the entire growth. The prognosis at best is grave, but recently some happy results have been reported, cures lasting for ' several years (see Table III), as much as ten in one instance, with- out recurrence, the children then passing from observation. Unfor- tunately, however, recurrence and speedy recurrence is still the rule, and the children die early from malignant toxemia or from pressure on the bladder and rectum and absorption toxemia. ** Sarcoma of the Uterus, Rev. de gyn., 1905, ix, 579. ** Kelly and Noble, Gynecological and Abdominal Surgery, i, 98.