Primary sarcoma of the peritoneum / by J.M. Elder.

  • Elder, John Munro, 1859-
Date:
1908
Catalogue details

Licence: In copyright

Credit: Primary sarcoma of the peritoneum / by J.M. Elder. 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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    longitudinal muscle. The submucosa is densely packed with tumor cells, more so than any other layer of the gut. There is also a band of similar cells lying beneath the serosa and between it and the outer muscle layer. Upon the surface of the serosa there is a collection of loose tissue made up of similar cells and a small amount of fibrous tissue; apparently this con- dition is due to the infiltration of old adhesions. Diaphragm.—The muscle fibres present are for the most part cut longitudinally; striations are well marked. The individual fibres are widely separated by masses of tumor cells which extend in long solid columns between the muscle fibres. These cells make up the greater part of the section. At the edges of the section the tumor elements are more densely aggregated than those that have infiltrated the muscle. Pancreas.—The alveolar tissue about the organ is composed almost entirely of tumor cells. In places these project down into the substance of the pancreas, for the most part following the trabeculae, though there are places where they break through the connective tissue capsule of the lobes and scatter all through the acini. [For the foregoing report, the author wishes to thank Dr. C. W. Duval, the hospital pathologist, and Dr. F. D. Gurd, his assistant.] As was hinted in the beginning of this paper, I was aston- ished in looking through such surgical works of reference as were at my command, to find so little written upon this subject. Most writers do not mention the subject at all, while others say that while the condition might occur it must be extremely rare. In Sajous’ “ Analytical Cyclopaedia of Prac- tical Medicine” (1901), vol. v., p. 436, I found the best reference: “ Sarcoma of the mesentery is of rapid growth and almost always ends fatally. Ascites is usually present. There is rapid involvement of surrounding structures, mak- ing removal impossible.” A review of the literature from 1896 to 1900 follows, which shows that out of 57 cases of solid tumors of the mesentery reported, 11 were sarcoma. One case, that of a physician, is reported, in which a diagnosis of cirrhotic liver was made, based upon ascites and inability to