Fibromyoma of the uterus complicated by cancer or sarcoma : with report of thirty-five cases / Ellice McDonald.

  • McDonald, Ellice, 1876-1955.
Date:
1909
Catalogue details

Licence: In copyright

Credit: Fibromyoma of the uterus complicated by cancer or sarcoma : with report of thirty-five cases / Ellice McDonald. 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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    From the foregoiner collection it may he poeii that. 1 while the age is not noted, adenocarcinoma occurs as a complication of fibroids in l.o per cent, and squamons carcinoma in 1.3 per cent. In the cases rc])orted in this paper adenocarcinoma occurred in 2.9 per cent, and squamons carcinoma in 0.8 per cent.; in other words, there were three times as man}' cases of adenocarcinoma as there were of squamous carcinoma. This i^roportion is entirely the reverse of the usual proportional occurrence, as is shown by Fiquand's col- lection of 1,135 cases of uterine cancer, in which he found 100 cases of squamous carcinoma to IT cases of adenocarcinoma; and also from the records of the Johns Hopkins Hospital,* where there were found 412 cases of squamous carcinoma and T8 cases of adeno- carcinoma, a proportion of 100 to 18. It is obvious, therefore, that adenocarcinoma is rela- tively more 'frequent in association with fil>roid tumors than is squamous carcinoma. This relationship may result from a common etiologic factor, or the fibroids may predispose toward the occurrence of adenocarci- noma of the fundus. dhie fact that myoma of the uterus, as is well known, ])redisposcs toward sterility, and that squamous carci- noma is found but seldom in women who have never had children, may have something to do with the ap- parent frequency of adenocarcinoma; in other words, women who have fibroids have no children and so are not likely to have squamous carcinoma of the cervix*. Although this may seem apparent, the argument on investigation develops several flaws. First of all, the percentage of sterility has been estimated by gynecolo- gists on operative cases, as is shown by the proportion of sterility given by Mann,” G4 per cent.; Frederick, 52.8 per cent.; Giles, 60 per cent., and Cullen, 52 per cent. It is obvious that if the percentage of 14.8 of occurrence of fibroids is correct, as shown by mv autopsies reported in 1904, so that one woman in seven lias a fibroid tumor, many women who never see •Sampson, .lolin A.: Importance of an Karly ItiaKnosis In Cancer of the T'terus, Tiik .Touii.xAi. A. M. A., lito.'), .kUv, l.'iSG. 5. Mann: Am. .Tour. Obst., .Inne, 1907. (J. Frederick : Am. G.vncc., 1902. i. 7. Giles : I.ancet. London, March 2. 1907. ,S. Cnilcn : Cancer of the Clerns, 1900.