Primary carcinoma of the veriform appendix : a critical study of 90 cases, with references to 123 cases / by Clarence A. McWilliams.

  • McWilliams, Clarence A.
Date:
[1908?]
Catalogue details

Licence: In copyright

Credit: Primary carcinoma of the veriform appendix : a critical study of 90 cases, with references to 123 cases / by Clarence A. McWilliams. Source: Wellcome Collection.

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    of predilection for cancers, are likewise most exposed to nutri¬ tional changes, due to malpositions and twistings, all of which conduce to decadence of tissues. When all is said that can be said in favor of the view that the chronic inflammation is the precursor and cause of the develop¬ ment of the cancers, no one can deny that the reverse may be true, namely, that the cancer causes the chronic inflammatory changes. To this latter view, it may be objected that the chronic symptoms have, in many of the instances, existed for so long a period of time, years in some of the cases, as to make the existence of can¬ cer for so long a period improbable. This objection, however, may be met by the statement that these primary cancers of the appendix are more than likely of very slow growth, particularly in the beginning. At present we are not in the position of being able to state positively which is primary, the cancer or the chronic changes in the appendix. Macroscopic Appearance of the Appendices.—Informa¬ tion is afforded by a perusal of the records as to this point in 42 cases. The analysis shows some interesting results: 1. No tumor was present to the naked eye in 14 cases (33.3 per cent.) of the 42 cases. These were Cases 3, 4, 5, 6, 7, 9, 13, 15, 18, 19,33,37,42,43. 2. A cyst was present in 3 cases (0.7 per cent.); size (a) small, No. 20; (b) bean, No. 1; (c) large, No. 29 ( 4 inches long by 2f wide, with a twisted pedicle). 3. One or more solid tumors were present in 23 cases (55 per cent.), (a) Single tumor, 19 cases: size (1) small, 4 cases, Nos. 24, 25, 36, 39; (2) pea, 13 cases, Nos. 2, 10, 12, 14, 16, 21, 23, 26, 30, 31, 44, 49; (3) bean, 2 cases, Nos. 17, 45. (6) Two tumors, 3 cases, Nos. 8, 28, 32. (c) Numerous tumors, 1 case, No. 35. 4. Clubbed tip only, 2 cases, Nos. 11 and 34. 5. In 9 cases there were found obliterated areas (“cicatrices”) which later under the microscope were discovered to be cancerous cicatrices. These were Cases 3, 5, 7, 14, 21, 25, 33, 36, 37.