Sarcoma and cirrhosis of the liver / by W.W. Ford.

  • Ford, William W. (William Webber), 1871-1941.
Date:
[between 1895 and 1910?]
Catalogue details

Licence: Public Domain Mark

Credit: Sarcoma and cirrhosis of the liver / by W.W. Ford. Source: Wellcome Collection.

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    rhosis of Lsennec or the alcoholic cirrhosis, and the clinical history of the patient and the development of ascites are both explained by the condi¬ tion of this organ. The presence of the huge mass of sarcomatous tissue in the right lobe of the liver is somewhat more difficult to explain. It is a definite sar¬ coma of a combination of round and spindle cells. Sarcoma of the liver occurs in two varieties, primary and secondary. The primary sar¬ comas are exceedingly rare, and it has often been doubted by patholo¬ gists whether they ever do occur. Genuine cases are recorded, however, by Horup, Lancereaux, Arnold, Windrath, Waring, von Kahlden and others. Such tumors are said to arise from the walls of the portal vein and from the smaller bloodvessels, and von Kahlden states that fre¬ quently older cirrhotic changes in the liver exist as well. While the presence of cirrhotic changes is admitted by Quincke and Hoppe-Seyler to be a possible factor in causing the development of carcinoma of the liver, they do not admit that a similar cirrhotic condition is capable of producing sarcomatous growths. Those writers who believe that cirrhosis may cause sarcoma, do not quote any cases in which such a definite combination has been seen. Secondary sarcomas occur in the form of metastatic tumor nodules scattered through the substance of the liver, or in the form of a diffuse sarcomatous infiltration. The primary seat of such a tumor is usually the skin or the choriod coat of the eye. The most frequent variety of secondary sarcomas is the melanotic sarcoma, the metastases of which give the liver a dark-brown or black appearance on section. The pres¬ ent sarcoma was not melanotic, and the pigmented coat of the eye and of the skin may be eliminated as a primary seat for this growth. Its presence as a large tumor nodule in one lobe of the liver, unasso¬ ciated with any other nodules of this organ and unassociated with any tumor nodules in other parts of the body, except the small metastases in the peritoneum and omentum, point to its being possibly primary in the liver. This cannot be stated with positiveness, however, for it is impossible to eliminate as the primary cause of any tumor masses in the liver a tumor of some one of the other organs, or some variety of cutaneous tumor which might have been removed years prior to the autopsy. It is a common occurrence in large autopsy-rooms to find sec¬ ondary tumor masses in the internal organs of the body which give com¬ paratively few symptoms during life, and which are not necessarily the cause of death, the presence of which is explained only by the discov¬ ery that the patient had, possibly some years previous to his death, some tumor removed from the skin or subcutaneous tissues. The pea-sized bodies in the omentum and in the peritoneum were evidently derived from the tumor of the liver, or possibly from that tumor, which might have been the primary seat of both. At any rate,