A case of primary adeno-carcinoma of the Fallopian tube / by Elizabeth Hurdon.

  • Hurdon, Elizabeth, 1868-1941.
Date:
1901
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Licence: In copyright

Credit: A case of primary adeno-carcinoma of the Fallopian tube / by Elizabeth Hurdon. 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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    blood and a quantity of substance looking like partially organized fibrin was drawn out, evidently from the lung substance.” This material was found on microscopic exami- nation to be composed of masses of sarcoma cells. The autopsy confirmed the diagnosis. I (4) Girvin and Steele have recently reported a case of ‘carcinoma of the pleura, diagnosed by tissue removed in (tapping. In conclusion, I desire to thank Dr. Osier for allowing me to report this case, and Dr. Arthur J. Wolfe, of Hartford, for the photomicrograph which accompanies this article. 3. Warthin: Med. News, New York, 1897, lxxi, pp. 489- 494. 4. Bahrenberg: Cleveland Med. Gaz., 1895-6, xi, pp. 274- 278. 5. Bogehold: Berl. klin. Wchnschr., 1878, xv, pp. 347-349. 6. Quincke: Deutsches Archiv f. klin. Med., Leipz., 1875, xvi, pp. 121-139. 7. Rieder: Op. cit. 8. Lenhartz: Mikroskopie und Chemie am Krankenbett, Berlin, 1895, p. 321. References. 1. Dock: Am. J. Med. Sc., Phila., 1897, cxiii, pn.iH>5-668. [ 2. Rieder: Deutsches Archiv f. klin. Med., Leipz., 1895, liv, pp. 544-554. 1^1 9. Prentiss: Trans, of the Assoc, of Am. Phys., 1893, viii, pp.' 191-194. TO.. Girvin and Steele: Proc. Path. Soc., Phila., 1901, New Series iv, pp. 164-166. )r— . r- r -n A CASE OF PRIMARY ADENOCARCINOMA OF THE FALLOPIAN TUBE. '-O ? uy/ By Elizabeth Hurdon, M. D. ; Clinical Assistant in Gynecology, The Johns Hopkins Hospital Dispensary. New growths of the Fallopian tube were seldom mentioned by the older writers, and by some, primary tumors were believed not to exist. The descriptions of the early cases are so meagre that in most instances there is not sufficient evidence that the growth was not due to a metastasis from a tumor arising elsewhere. The first undoubted case of prim- ary cancer was described by Orthmann 1 in 1888, and since then thirty-four additional cases have been recorded. The tumor in most instances originates in the epithelium covering the folds of the mucosa and has, therefore, a well marked papillary structure. Friedenheim,2 however, has described a case in which the tubal folds are practically normal, while the muscular coats are infiltrated with carci- nomatous masses. This growth, as the writer suggests, prob- ably originated in the gland-like structures, sometimes found in the tube walls. Most observers are of the opinion that a close relationship exists between the development of the carcinoma and the presence of a chronic inflammatory process. It seems prob- able that this is an important predisposing factor, in many cases the characteristic changes resulting from an old inflam- mation were demonstrable and in some the opposite tube was converted into a sac containing serous or purulent fluid. The history of sterility so generally obtained and often definite attacks of pelvic inflammation tend to support this view. Alban Doran3 believes that carcinoma is sometimes due to malignant changes in a simple papilloma, which itself may be traced to inflammatory disease. The case reported by 'Orthmann: Zeitschrift fiir Geburtsh. u. Gyn. Bd. xv, 1888. J Friedenheim : Berliner klin. Woch., No. 25, 1899. 3Doran: A System of Medicine, Albutt & Playfair. Trans, of the ondon Obstet. Soc., vol. xl, 1898, Kaltenbach 4 and the first case of Fabricius5 possibly belong to this group. Only a brief history of the present case could be obtained, and is as follows: Case No. 576, aged 63. Admitted to Dr. Kelly’s private sanatorium March, 1898. Complaint, sanious vaginal dis- charge, elevation of temperature. The patient had had four normal labors and had enjoyed perfect health until the summer before admission, when she suffered from an attack of typhoid fever, after which she noticed an almost constant blood-tinged vaginal discharge, and was subject to frequent rises of temperature. Examina- tion under an anesthetic revealed an irregular mass about the size of a mandarin on the left side of the uterus. The tumor was of rather soft consistency and was adherent. The right tube and ovary were apparently normal. The uterus was small and on curetting no tissue was removed. Pyosalpinx was diagnosticated and operation advised. Operation.—Abdominal hysterectomy, right salpingectomy, left salpingo-oophorectomv. The right ovary, which was small and perfectly normal, was left in situ. The uterus, right tube and left tubo-ovarian mass were removed without difficulty, but in separating some widespread adhesions which surrounded the mass on the left side,, the sigmoid was at one point torn through to the mucosa. This rent was repaired with a mattress suture of catgut. The patient made an uneventful recovery. Gyn. Path. No. 2376. The specimen consists of the uterus, the right tube and a left tubo-ovarian mass. The uterus is small and free from adhesions. Its mucosa is from 4 Kaltenbach : Centralblatt, f. Gyn., 1889, p. 74. 5Fabricins: Wiener klin. Woch., 1899, No. 49.