A case of secondary hypernephroma of the iris and ciliary body / Burton Chance.

  • Chance, Burton Kollock, 1868-1965.
Date:
1907
Catalogue details

Licence: In copyright

Credit: A case of secondary hypernephroma of the iris and ciliary body / Burton Chance. 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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    ? choroidal inflammation was extending in all directions. The condition of the right eye remaired unchanged. Early in January, 1906, the man’s testicles had become somewhat enlarged and he complained of pain and heaviness. I referred him to Dr. Hilary M. Christian. Later, he turned up in Dr. Christian’s ward at the Philadelphia General Hos- pital, where he was treated with anti-syphilitic remedies. While there, a number of small nodes were noticed lying be- neath the skin on his thorax, like those I had discovered while he was under my care. These softened and became smaller when mercury was pushed, in the same manner as those which I have already described. Several of them were excised, and pronounced sarcomata by Dr. Rosenberger, path- ologist of the hospital. On January 26, the man was anxious for me to see his eyes, and he asked to be allowed to come to me. To all appearances the ocular conditions had not changed; but on February 1, he came again, complaining of intense pain in the left eye. There was a small foreign body on the cornea, but, in addi- tion, the cornea was steamy and surrounded by a ring of ciliary injection, while the iris was obscured by the turbid aqueous. The tension was not elevated. I removed the foreign body and bandaged the eye after instilling solutions of cocain, dionin and atropin. Four hours later the symptoms had not abated. A day or two later, I was informed that he had returned to Blockley, but this time he entered the Eye Wards. On February 7, I was invited to visit the patient through the courtesy of Dr. John Welsh Croskey, the alternate of Dr. Charles A. Oliver who was unable to serve at the hospital 'because of an illness. The patient’s ocular symptoms had become more profound. There was greater injection, greater cyclitis, haziness of the lens, a more clouded vitreous and an indistinct fundus. The in- traocular tension was elevated, and yet the tension of the right eyeball was equal to that of the left. The man lay curled up in his bed; he had lost weight, and presented signs of cachexia. In the days following, the pain increased so greatly that he begged for the removal of the eye, fearing the right eye might become similarly diseased. On Saturday, February 17, Dr. John Welsh Croskey removed the eye, and the large inguinal gland also; he most kindly gave the specimens to me. The globe measured 25 mm. in the anteroposterior diameter, 23.5 mm. in the vertical, and 23 mm. in the transverse. It had been most cleanly dis- sected from the socket; the sclera being smooth, and the at- tached nerve, which measured 6 mm. in length, appeared healthy. No tumor was detected in the globe by transillum- ination, and on section of the globe no evidences of a neoplasm were apparent. The vitreous chamber contained a shrunken