Some unusual cases of orbital tumors : emphasizing the necessity of careful differential diagnosis / by Charles Stedman Bull.

  • Bull, Charles Stedman, 1844-1912.
Date:
[1895]
Catalogue details

Licence: Public Domain Mark

Credit: Some unusual cases of orbital tumors : emphasizing the necessity of careful differential diagnosis / by Charles Stedman Bull. Source: Wellcome Collection.

Provider: This material has been provided by UCL Library Services. The original may be consulted at UCL (University College London)

    6/20 (page 4)
    introduced well into the ethmoid cavity, and cold dressings applied. As soon as the patient had regained consciousness she was placed in a sitting posture in bed, and kept in this position for three days. The ethmoid cavity and nostrils were irrigated twice a day with the antiseptic solution, and on the fourth day the drainage-tube was removed. There was little or no reaction, the purulent discharge rapidly sub- sided, the wound granulated from the bottom, and in two weeks the patient was discharged. At the end of a month the diplopia had disappeared, and there was only a trace of exophthalmia left. In this case the mistake in diagnosis was due to the appearance and feeling of the tumor, to the absence of all signs in the nose at first, and to placing too much impor- tance on the family history of cancer. Case II. Adeno-sarcoma of the Lacrymal Gland.—In May, 1889, a gentleman, aged thirty-five years, was sent to me complaining of an annoying excrescence of one of his lids, as he called it. An examination showed a protrusion of the outer angle of the left upper lid of considerable extent, and a slight displacement of the eyeball downward and inward. On everting the lid a dark-red, lobular mass presented itself, which occupied the upper and outer angle of the orbit, and seemed to be firmly attached to the periosteum. It was closely applied to the eyeball and appeared to extend some distance back into the orbit. The tumor was hard and non- sensitive, and occupied the site of the lacrymal gland. It had been growing for more than a year, but had occasioned no pain and had only recently become annoying. It was freely movable over the eye, but was firmly attached to the bone. No family history of any significance was elicited. A diag- nosis was made of tumor of the lacrymal gland, probably malig- nant, and the patient was advised to have it removed imme- diately, before any further extension to the orbital tissue, and to this he consented. The operation was done at his resi- dence as follows: Under ether anaesthesia the external can-