Two cases of uterine fibroid showing peritheliomatous changes : long immunity from recurrence after operation / by Alban H.G. Doran and Cuthbert Lockyer.

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

Credit: Two cases of uterine fibroid showing peritheliomatous changes : long immunity from recurrence after operation / by Alban H.G. Doran and Cuthbert Lockyer. 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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    Tvvw — matous changes: Long Immunity from Recur- rence after Operation.* Jtt. BY Alban H. G. Doran, F.R.C.S., Senior Surgeon, Samaritan Free Hospital, Ctjthbert Lockyer, M.D., F.R.C.S., Senior Physician to Out-patients, Samaritan Free Hospital. Now, when hysterectomy for fibromyoma of the uterus is performed widely and with great success, the question of the possibility of malignant elements lying concealed in an innocent-looking tumour of this familiar type has become of high importance. + Kynoch + describes a successful supravaginal hysterectomy for the removal of a bleeding fibroid : the patient was 48 years of age. The parts re- moved were put aside, very fortunately. Nearly a year later, a hard new growth, of the size of an orange, was removed from the anterior aspect of the right elbow. Then, for the first time, the fibroid was examined microscopically. Distinct sarcomatous degeneration was detected in its substance, and the secojidary tumour proved to be a sarcoma of the same type. The patient died six months after the second operation, with metastatic deposits in the abdomen. Many similar cases must have been overlooked. Circumstances were quite different in the two cases which we now bring forward. In both, Mr. Doran, the operator, suspected that the fibroid was very malignant when he amputated the uterus. So it was with Dr. W. C. Swayne’s cases, recently discussed before this Section. In both, Dr. Lockyer examined the tumour microscopically and detected what was histologically a true malignant change. Month by month after each operation the operator expected to hear bad news, and he actually received a false report about the death of the second patient, which for a time completely misled him. * Read at a meeting of the Obstetrical and Gynaecological Section of the Royal Society of Medicine, October 8th, 1908. t The literature of the subject is voluminous. For a convenient summary, see Kelly and Noble, Gynaecology and Abdominal Surgery (1907), p. 669. Sarcomatous degeneration was detected in 34 out of 2,274 cases (1.4 per cent.) of uterine fibroid in their statistics. t“Zwei Falle von malignen Fibromyom des Uterus.” Archiv f. Gyndk., vol. lxxxii, p. 264. AND