A study of metastatic carcinoma of the stomach : report of a case of primary carcinoma of the testicle, secondary involvement of the vena cava inferior, metastases in the lungs, stomach, and falx cerebri / by John S. Ely.

  • Ely, John S.
Date:
1890?]
Catalogue details

Licence: Public Domain Mark

Credit: A study of metastatic carcinoma of the stomach : report of a case of primary carcinoma of the testicle, secondary involvement of the vena cava inferior, metastases in the lungs, stomach, and falx cerebri / by John S. Ely. Source: Wellcome Collection.

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    In the lungs many of the smaller bloodvessels are plugged by masses of epithelial cells, similar in every particular to those described as occu¬ pying the alveoli of the cancerous tissue in the various organs. They must be regarded as emboli of carcinomatous material, demonstrating that the blood current has been, in the present case, the transporter of much of the infectious material from which metastases developed (Fig. 2). Fig. 2. Group of bloodvessels in the lung, two of which are plugged by emboli of cancerous material. The tissue of the lung in the immediate neighborhood is somewhat infil¬ trated with small spheroidal cells, and there is broncho-pneumonia. The other two bloodvessels contain ordinary clots. [X 50.] We have, then, a case of primary encephaloid carcinoma of the right testicle with secondary growth along the course of the lymphatics of the pelvis and spine, involvement of the vena cava inferior, growth through its wall, infection of the blood, and metastases in the lungs, stomach, and falx cerebri. The picture, as a whole, is not unusual. Carcinoma of the testicle, though not of as frequent occurrence as sarcoma of that organ, is by no means rare, is usually of encephaloid variety, commonly affects but one gland, and frequently follows traumatism of some kind. Its mode of extension, too, is usually that exemplified by the present case, along the lymphatics accompanying the spermatic bloodvessels, and an almost constant sequel is the formation of metastases. One fea¬ ture of the case, however, demands consideration: metastasis in the stomach. Striking verification of Virchow’s aphorism that tumors occur most rarely as metastasis in those organs in which, as primary growths, they appear most often, exists in the relative frequency of primary and metas¬ tatic carcinomata of the stomach. As is well known, the stomach is one of the most frequent sites of primary cancer: metastasis in its wall is, on the other hand, a great rarity. Among statistics, tabulated by Coup- *