Surgical lectures and essays / by A. Marmaduke Sheild.

  • Sheild, A. Marmaduke (Arthur Marmaduke)
Date:
[1904?]
Catalogue details

Licence: In copyright

Credit: Surgical lectures and essays / by A. Marmaduke Sheild. Source: Wellcome Collection.

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    centre. It was noticed that a considerable quantity of fluid drained away from the tumour into the vessel in which it lay, so that shortly it was surrounded by straw- coloured serum. Microscopical examination revealed the fact that this tumour was an example of a very rare formation in the breast, pure fibroma. It was full of serum, soft and fluctuating, reminding* one of those oedematous fibromata of the uterus which so exactly simulate cystic growths and so often deceive abdominal operators. This short history carries its own lessons for reflection. I feel confident that any surgeon of experience who had examined this tumour before exploration would have felt sure it was cystic. The swelling fluctuated obviously and was quite elastic. The naked-eye appearances of sarcoma were exactly simulated, and it seems impossible to avoid, acting for the safety of the patient, removing the whole mamma in such exceptional tumours. An apparently Cystic Swelling in the Mamina proving to he of a Sarcomatous Nature. A single lady, aged 42, had noticed a swelling just above the left nipple for about four months. It was detected accidentally, and might have existed longer. Occasionally it was the site of slight throbbing pain. The nipple was not retracted and there was no history of nipple dis- charge. The skin was not implicated in the least. The swelling was about the size of a pigeon’s egg. It was elastic and apparently fluctuated, so that I felt very clear that it was a cyst. The same opinion had been expressed by surgeons both in Florence and at Rome, and at the former place the injection treatment had been proposed by an eminent authority. Fearing from the age of the patient that the case might not prove quite simple, I urged the propriety of exploratory incision, the treatment as to extent of removal being determined by the appear- ances thus disclosed. Opposition was offered to complete 9