A malignant adenoma of the adrenal with transformation into sarcomatous tissue / by J.C. Meakin.

  • Meakins, J. C.
Date:
[1908?]
Catalogue details

Licence: In copyright

Credit: A malignant adenoma of the adrenal with transformation into sarcomatous tissue / by J.C. Meakin. Source: Wellcome Collection.

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    272 mitted to the Presbyterian Hospital on January 6, 1908, in the service of Dr. Eliot. I wish to express my thanks to Dr. Eliot for permission to report the following facts concerning the history of the case: The patient, W. N., was white, male, aged forty-five years, and by occupation a letter carrier. His family history is unimportant. He was bom in the United States, where he has always lived. Many years ago he used alcohol in moderation, he had gonorrhcea in 1897. Otherwise his history contains nothing noteworthy. In 1905 the patient had hematuria for a week without sub¬ jective symptoms. He remained in good health until December 24, 1908, when he noticed that his urine was dark brown. Three days later he suddenly developed severe pain in the left flank. It was not influenced by deep respiration or by movement, but on assuming the right lateral position it was greatly increased. No bright red blood was observed in the urine. Physical examination revealed a prominence in the left flank and on palpation a large, tender tumor was found in this region. It disappeared under the costal margin and could be moved only in an antero-posterior direction. There was flatness from the fourth intercostal space to the crest of the ileum, concealing the splenic dullness. When the patient assumed the right lateral position the tumor approached almost to the median line. The heart, lungs and nervous systems were normal. Blood examina¬ tion showed no abnormality. The urine was dark brown, acid, and had a specific gravity of 1020. It contained about 0.1 per cent, albumin, and no glucose. Microscopical examination revealed hyaline and granular casts, many red blood cells, leucocytes and epithelium. Urea was 2.7 per cent. The ureters were catheterized and the urine from the two sides had practically the same characters, but the right kidney was excreting the greater amount. On January 6, 1908, Dr. Eliot found at operation a large, firm, nodular mass, occupying the site of the left kidney. It