A demonstration of specimens illustrating cysts of the female appendages / by Arthur Keith ; with notes, by Alban Doran.

  • Keith, Arthur, Sir, 1866-1955.
Date:
1910
Catalogue details

Licence: In copyright

Credit: A demonstration of specimens illustrating cysts of the female appendages / by Arthur Keith ; with notes, 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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    other hand, a series in the Museum of the College shows the gradual development of the minute fimbrial cyst into a large cystic broad ligament tumour, which, as has been explained, must not any longer be. called parovarian. In all, however minute or bulky, the ovarian fimbria can be traced along the surface of the cyst, lying on the mesosalpinx. Compare this specimen (Fig. 6), where the Wolffian body or parovarium is seen to be quite internal to the cyst, with this example, of a small but very typical broad ligament cystic tumour (Fig. 7). The course of the ovarian fimbria is plain, the alteration of relations to the Fallopian tube itself is caused by the opening up of the mesosalpinx by the growth of the cyst, which soon touches and afterwards stretches the tube itself. But even in the enormous broad ligament cyst (No. 4589 A), presented by Mr. Bland- Sutton, the relations of the ovarian fimbria to the cyst remain the same as in the most minute fimbrial cyst. The ostium of the tube opens on the surface of the cyst, in the characteristic manner long familiar to the pathologist, and from the ostium several low ridges of plicae run along the cyst for over nine inches, ending on the outer pole of the ovary. Those ridges represent the ovarian fimbria. We. need not neglect the Wolffian body, epi-oophoron, organ of Bosenmuller, or parovarium, simply because it is never the parent of a big cyst. It is large in mid-foetal life and may have some function. The six small cysts above mentioned as undoubtedly Wolffian w^ere all derived from the vertical tubes. Dr. Keith has never detected a cyst arising from the horizontal tube, more properly called the beginning of the Wolffian duct. The paravaginal portion of the Wolffian duct, conspicuous iu some of the lower mammalia, is the structure to which the name of Gartner, a Danish anatomist,^ has been given. It is hardly correct to apply the name Gartner’s duct to the free portion of the Wolffian duct between the Wolffian body and the uterus, sometimes persistent in our species (Fig. I, b'). The inferior termination of the Wolffian ducts is not represented in Homo by Skene’s tubes, but most likely by a pair of shallow depressions in the vestibule. Lewers operated on a cyst which, in his opinion, originated in the lower part of the Wolffian duct.^ 1. Herman Treschow Gartner. He obtained a silver medal from the Royal Danish Society of Sciences in 1822 for a treatise, “ Beskrivelse over et ved nogle Dyrarters Uterus undersogt glandulbst Organ.” (Description of a glandular organ examined in the uterus of certain species of animals.).—A.D. 2. “ Note on a Case of Cystic Tumour of the Right Broad Ligament springing from Uterus, and apparently developed from Gartner’s Duct.” Proc. Poyal Sor. Med.^ Ohstetr. and Gyn. Section, Jan. 1910, p. 67. (It was, if really of Wolffian origin, derived from the parauterine part of the Wolffian duct, not from the terminal or vaginal segment, “Gartner’s duct.” See also Amand Routh, “On Cases of Associated Parovarian and Vaginal Cysts, formed from a Distended Gartner’s Duct,” Trans, Ohst. Soc., Land., VoL xxxvi, p. 152).—A.D,