Acromegaly / by Maximilian Sternberg ; translated by F.R.B. Atkinson.

  • Sternberg, Maximilian, 1863-
Date:
[1899]
Catalogue details

Licence: Public Domain Mark

Credit: Acromegaly / by Maximilian Sternberg ; translated by F.R.B. Atkinson. Source: Wellcome Collection.

    23/186 (page 19)
    As a result of this, the hones acquire a coarse appearance, and the normal roughness of the surface is thereby increased. This change of shape exliibits a partial exaggeration of the normal proportions. Moreover, small exostoses appear on the outside of the muscular and ligamentous attachments. Minute consideration of the normal topographical relations is often necessary regarding these osseous deposits to dis- tinguish them from the former. They are small, rarely prickly, and are placed most abundantly on the bones of the base of the skull, Tertebrce, pelvis, and chest, very few on the bones of the extremities. They are far more scanty than the normal strong points and.prominences. Prickly, warty, stalactiform exostoses are never found to any great extent in true massive acromegaly on normally smooth parts of the bones. Typical further is a pecidiar growth of some bones (lower jaw, bones of the air sinuses, sternum). The tumour of the pituitary body produces in most cases special changes in the sphenoid bone. The extent of the changes depends naturally on whether, on dissection, the case is found to have reached an early or later stage. The skull is frequently enlarged as a whole, often also thick-walled (see Pig. 10, p. 54), coarse and heavy, especially if the disease has lasted a long time. The circumference of the skull is, in a n\nnber of cases, considerably enlarged (size during life : Sigurini and Caporiacco G1‘0, PTnverricht 02’S, Holsti G3*o, Yirchow-Mobius G5‘5, Haskovec GG‘0, Schultze GT‘0), in other cases normal. On the outer surface of the cranium the strong and very rough muscular tubero- sities are characteristic, as the side view in Figs. 5 and 7 shows. Frequently the occipital protuberance projects promi- nently (Fig. 7). The under surface of the skull, the site of the numerous ligamentous and muscular attachments, is extremely rough and jagged, the styloid process of the tem- poral bones most extraordinarily strong. The air sinuses are Avidened,* usually not all to the same extent. If the dilatation depends on inflation of their outer Avail, the shape of the skull is thereby strongly affected, as also by the * The frontal sinnsc.s would be oiiened in acromegaly by a saw-cut through the nsnal horizontal ]>lane of the skull, 1 cm. above the orbital curve, which other wise is rarely the case.