The course and prognosis of orbital tumors as influenced by surgical operations for their removal / by Charles Stedman Bull.

  • Bull, Charles Stedman, 1844-1912.
Date:
[1896]
Catalogue details

Licence: Public Domain Mark

Credit: The course and prognosis of orbital tumors as influenced by surgical operations for their removal / 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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    Within one month the tumor again grew from the sphenoidal fissure and increased rapidly in size. The patient became ema- ciated ; developed a low fever, and sank steadily, and death occurred just five months after the last operation. Case XVII. A lady, aged 35, first seen December 16, 1880. The right eye had been gradually failing in vision for more than a year. There was a small tumor in the infero-nasal quad- rant of iris, directly continuous with a tumor of the ciliary body, and detachment of the retina, downwards. The eye was enu- cleated and immediately bisected. The intraocular tumor was found to involve the choroid as far back as the optic nerve, and the nerve was diseased. This necessitated the immediate exenteration of the entire contents of the orbit, including the periosteum, which was done at once, and the bones were then cauterized. Nothing suspicious was observed in the orbit for four months, and then a peculiar swelling of the inner wall was noticed, which increased steadily, but not very rapidly, for two weeks, when its nature became unmistakable. The second operation consisted in the removal of the inner wall of the orbit, and as much of the internal structure of the ethmoid as could be reached. The latter was a gelatinous gray mass which con- tained a mass of small cells in a myxomatous matrix. The re- turn of the disease in the ethmoid cavity was very rapid after this second operation, so that in five weeks the orbit was nearly filled. A third operation for the removal of the orbital contents showed that the growth had invaded the sphenoid bone and upper cavities of the nose. The patient declined any further surgical interference, and died in about eight months, with head symp- toms pointing to an extension of the tumor to the intracranial cavity. The growth filled the orbit and nose, protruded into the pharynx, and had extended from the orbit, downwards upon the cheek, and outwards upon the temple. Case XVIII. A lady, aged 45, first seen August 1, 1881. There was a growth of the ocular conjunctiva of the left eye, on the temporal side near the corneal margin, which was as large as a bean, and had been growing for two months. It was carefully excised, and the sclera cauterized. The growth returned early in October, and by November 21st it involved the upper, outer, 8