Branchial carcinoma / by Charles A. Powers.

  • Powers, Charles A.
Date:
1898
Catalogue details

Licence: Public Domain Mark

Credit: Branchial carcinoma / by Charles A. Powers. 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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    brane normal. Partial extirpation. “ Squamous-celled car- cinoma.” Case XX.—Eigenbrodt.20 Male, aged sixty-two years. Tumor of neck. Extirpation. “ Branchial carcinoma.” No re- currence at end of two years. In this operation a portion of the vagus was resected, and for some time after this there was a quickening and irregularity of the pulse, together with paralysis of one vocal cord. Pressure over a certain portion of the scar excited an irresistible attack of coughing. When we study the origin and growth of these tumors we find the task a simple one. They are to be classed with the teratomata; their origin is from the inclusion epithelium left during the imperfect closure of a branchial cleft. This epi- thelium may be from the skin or from the mucous membrane of the pharynx. So, from this non-closure of one of the clefts we may have a branchial fistula, or from a proliferation of the contents a branchial cyst, while the epithelial growth may in- vade the tissues and result in an epithelioma of ordinary his- tological structure. The tumor-matrix is congenitally dis- placed epithelial tissue, and this epithelium may proliferate just as may epithelium elsewhere. The cells of the growth are of the flat variety. It is not probable that accurate diagnosis can be arrived at in many of these tumors before they are removed and his- tologically examined. The diagnosis must rest on this: that an epithelioma of the neck which does not involve the skin or mucous membrane, and in which no original focus can be found in these structures, is to be looked upon as a branchio- genic carcinoma, and in our clinical examination of deep cer- vical tumors it is well for us to bear in mind the possibility of their being of this nature. At the meeting of the French Surgical Congress, in October, 1897, Berger (Gazette Medi- cate de Paris, October 23, 1897) called attention to the fact that outlying accessory thyroid glands may take on a malig- nant growth, and that these are to be differentiated histologi- cally from the branchial tumors of von Volkmann. Analysis of the reported cases is not of especial interest.