Volume 1

Atlas of clinical medicine, surgery, and pathology / edited under the direction of the Council by Jonathan Hutchinson.

  • New Sydenham Society.
Date:
1901-1907
Catalogue details

Licence: Attribution-NonCommercial 4.0 International (CC BY-NC 4.0)

Credit: Atlas of clinical medicine, surgery, and pathology / edited under the direction of the Council by Jonathan Hutchinson. Source: Wellcome Collection.

Provider: This material has been provided by The University of Leeds Library. The original may be consulted at The University of Leeds Library.

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    PLATE CLXXX. SQUAMOUS-CELLED CARCINOMA OF LABIUM. Upper Figure. The patient was an unmarried lady, aged 56 years. Menstruation had ceased for four years. Three years before coming under observation she had noticed a small sore place on the right labium minus ; this became hard and increased in size. For a few months it had been painful. For about thirty years she had had irritation at the vulva, the parts chafing very readily. There was no vaginal discharge or loss of flesh. When seen by Dr. Cullingworth on March 9th, 1893, there was a soft growth on the right labium minus, close to the clitoris, of about the size of a cherry. There was also a small abraded surface on the left labium minus, about the middle of the vaginal orifice. The uterus was normal. There were some slightly enlarged glands in the right groin. The tumour was removed on March 16th, together with two inguinal glands. Three years later there was no recurrence; but in 1901, 1903 and J904, recurrent growths were removed from the vulva, mainly on the right labium majus. Lower Figure. The patient was a married lady, aged 50 years. She had had nine children and one miscarriage, and a phantom pregnancy occurred seven years before coming under observation. She had been getting thinner for some months despite a good appetite. She had suffered from a good deal of mental stress for some years. Menstruation had been regular up till nine months previous, since then it had only occurred twice. She stated that she had had ulcers on one labium several times at intervals for the past fifteen years. Six months before examination she noticed a sore on the labium with some swelling and eversion, for which she lay up and consulted a medical man. When first seen by Dr. Cullingworth on May 21st, 1889, there were several circular abrasions on the left labium with no induration of marofins and no enlargement of the glands in the groin. They were extremely tender. Two or three non-sensitive abrasions were present on the right labium. Vagina and uterus normal. Under local treatment a certain amount of healing took place, but the lower abraded surface showed a good deal of hardening, and its malignant character became apparent. After a consultation with Mr. Jonathan Hutchinson on July 27th it was decided to remove the left labium and the mucous membrane of the right. This was done and the growth was reported by Mr. Shattock to be a squamous-celled carcinoma. The wound healed rapidly. By February, 1890, a mass of glands had developed in the left groin as large as a pigeon’s egg, with a few small, hard glands in the right groin. There was no local recurrence. The glands were removed. In December, 1890, a malignant ulcer appeared on the perineum just in front of the anus ; it was about the size of a shilling with an indurated base ; operation was declined and the patient died in August, 1892, three years and nine months from the first appearance of the ulcer.