Ovarian tumours simulating inflamed ovaries : including a case of ovarian myoma / by Alban Doran.

  • Doran, Alban H. G. (Alban Henry Griffiths), 1849-1927
Date:
[1898]
Catalogue details

Licence: Public Domain Mark

Credit: Ovarian tumours simulating inflamed ovaries : including a case of ovarian myoma / by Alban Doran. 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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    part of the pelvis;1 in this instance it was apparently otherwise. It is a factor to be remembered, and I suspect that it often aggravates the pain when an inflamed ovary slips into Douglas’s pouch. The ovary was undoubtedly the seat of a true tumour, which had developed in the hilum, and, as is the rule under such conditions, it was papillomatous, and pushed the normal ovarian tissue aside instead of absorbing it.2 In short, it was neoplastic, and not inflammatory. The absence of menorrhagia rather favoured the diagnosis of a tumour. In the next case the trouble was due to a juvenile dermoid. Case 2.—M. M., set. 44; widow; last confinement thirteen years. She had suffered for nearly a year from severe pain, distinctly referred to the right side of the pelvis. The attacks were accompanied with dysuria. Catamenia perfectly regular, show moderate. On 26th February 1892 I made a note, “Uterus small; to left is a soft tender body, apparently adherent to pelvic wall.” On 11th April, same year, “The tender body is about double the size it had obtained in February, and can be pushed upwards.” Operation, 14th April 1892.—I removed a cystic tumour 3 in. in diameter; it had developed in the left ovary, and was absolutely free from adhesions. It contained oz. of pale yellow fat, mixed with hairs. The pedicle was narrow and rather short; it was not twisted. The right ovary and uterus were quite healthy and free froflTMhesions. The catamenia remained regular till just three years after the operation; then they ceased abruptly, when the patient was 47, never to return. Last autumn there was no evidence of any morbid change in the right ovary. Severe pain and a soft tender body were the principal clinical features in this case. As in the last, I could not feel sure whether the swelling was a new growth or an ovary subject to purely inflammatory changes. Pain in the pelvis, referred to the side opposite to the seat of disease, is quite common in chronic oophoritis. It was not necessarily due to the uterus being pushed laterally by the swollen or cystic ovary, as displacements from that cause do not specially accompany this curious symptom. As for the severe attacks, with dysuria, it is possible that they were due to occasional rotation of the pedicle. Ovarian dermoids are subject to this complication, even when they are small, and clinical histories indicate that partial rotation may be reversed, the pedicle once again lying normally. 1 No doubt many ovarian cysts never sink so low, but rise out of the pelvis almost from the first. 2 This condition is demonstrated in a similar specimen which I described some time ago, in a paper on “Papillary Cysts of the Ovary,” Trans. Path. Soc. London, vol. xxxiii. Plate ix. Figs. 2 and 3. The cyst described above is preserved in the museum of the Westminster Hospital, Series “Morbid Anatomy and Pathology,” No. 1030. See footnote, Case 4.
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