A case of cystic interstitial uterine fibroid appearing papillomatous / by Alban Doran.

  • Doran, Alban H. G. (Alban Henry Griffiths), 1849-1927.
Date:
1908
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Licence: In copyright

Credit: A case of cystic interstitial uterine fibroid appearing papillomatous / by Alban Doran. 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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    myxomatous degeneration of the connective-tissue the fluid contents of the cyst were not thick and tenacious, but perfectly fluid. The tumour was in fact a solitary interstitial fibroid which had become cystic by liquefaction of its connective-tissue. Remarks. This cyst was associated with a fihro-myoma, and Mercade, to whom I have referred, excludes from his groups all cystic tumours secondary to solid uterine growths. It differed, on the other hand, greatly from the commoner and well-known types of cystic fibroid and other mixed growths. For that reason it will he advisable to dwell for awhile on its negative characters. I shall then explain that I have only found one case recorded of a uterine cyst where the positive characters were in any way similar to those given in the above description of my own specimen, and in that case the cyst was not solitary, as in mine, but associated with several fibroid growths. It is clear that the cyst which I removed was not a chorio- epithelioma, nor a carcinoma of any type. It was not an instance of Yon Recklinghausen’s cystadenoma originating in Wolffian relics. It was not an adenoma. Cullen (Adenomyovia of the Uterus, p. 176) writes: “ Given a myomatous uterus containing large cystic areas with smooth velvety linings and chocolate-coloured contents, adeno- myoma will usually he found,” hut in this tumour there was one big solitary cyst; its lining was not smooth and velvety, and it contained a clear, not a chocolate-coloured fluid. The microscope revealed no glandular structures. Cullen, however, as will be explained, has come across a new growth not unlike that under consideration. Again, lymphangioma may be set aside. It is, in my experience, the commonest variety of “ cystic fibroid.” The dilated lymphatics form spaces which vary from microscopic proportions to big cavities holding many pints of clear pale yellow coagulable fluid. The lining membrane is smooth, being endothelium; the myomatous tissues lies outside, not inside, the cyst. Then it must be added that the tumour was not a true papilloma of any type. It did not lie in the line of Gartner’s duct; and Coblenz found that “ parauterine cystoma,” developed from the duct, was very rarely papillomatous (“ Zur Genese und Entwickelung von Kystomen in Bereich der inneren Sexualorgane,” Virchow's Archiv, Yol. lxxxiv, 1881). Amand Routh (“ On Cases of Associated Parovarian and Yaginal Cyst formed from a Distended Gartner’s Duct,” Trans. Obstet. Soc., Yol. xxxiv, p. 152) brings forward several cases where it seemed quite reasonable to suppose that in each instance the lower cyst was of Gartnerian origin, but it was vaginal, not uterine, and it did not bear papillomatous growths.