Some unusual cases of orbital tumors emphasizing the necessity of careful differential diagnosis / by Charles Stedman Bull.

  • Bull, Charles Stedman, 1844-1912.
Date:
[1895]
Catalogue details

Licence: Public Domain Mark

Credit: Some unusual cases of orbital tumors emphasizing the necessity of careful differential diagnosis / by Charles Stedman Bull. Source: Wellcome Collection.

Provider: This material has been provided by UCL Library Services. The original may be consulted at UCL (University College London)

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    pressure. The orbit was then thoroughly washed out with bi- chloride solution (1 to 1,000), and was then packed tightly with iodoform gauze, and a pressure bandage was applied over the closed lids. There was almost no reaction, and on the sec- ond day the packing was removed, the orbit again washed out, and the packing and bandage reapplied for two days jonger. The packing was then removed and cold dressings applied. The patient was discharged on the twelfth day, and he has had no return of any trouble since. An examination of the tumor showed some interesting features. It was found to occupy mainly the pyramidal space or funnel between the ocular muscles, but it extended outside the muscular barrier and involved the fatty tissue at the rear of the orbit and extended forward upon the eyeball. It sur- rounded the optic nerve, which was compressed by the growth. The unusually dark color of the tumor gave the impression of a melano-sarcoma, which was dissipated after it had been opened by a longitudinal incision. It was surrounded by a tough, thick capsule of very dense connective tissue, which under the microscope contained quantities of brown pigment, some in fusiform cells and some as free granules. In the centre were numerous vacuoles containing a thick, dark brown, grumous fluid. These vascular spaces were separated by tra- becule or partitions of connective tissue, which also contained pigment. Here and there on the walls of the lacunas were small patches of epithelium which were deeply stained. The points where the needles had entered in the operation of electrolysis were distinguished by the partial destruction of the connective-tissue envelope and the obliteration of the neighboring vacuoles. The optic nerve ran through the cen- tre of the tumor, and cross sections of the nerve showed atrophy of the nerve fibres, but no thrombus of the central retinal artery. Like all tumors of this nature, its progress had been very slow, but the only point in which it differed from similar cases was in the presence of a distinct pulsa- tion, which was not only felt by the patient but observed by the surgeon. Portions of the tumor were so solidified that I could not but think that had the electrolysis been persisted
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