Glioma retinae : with report of five cases / by Christian R. Holmes.

  • Holmes, Christian R. (Christian Rasmus), 1857-1920.
Date:
[1902]
Catalogue details

Licence: In copyright

Credit: Glioma retinae : with report of five cases / by Christian R. Holmes. Source: Wellcome Collection.

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

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    with the child. It was emaciated, exhausted and fretful, fre- quently crying- out in pain. The case was now well advanced into the second stage. Globe injected, tension +2, anterior chamber obliterated, pupillary area filled with a yellowish mass, slightly irregular, with a few fine vessels seen upon the surface. The family physician had now withdrawn his ob- jection to operation. Left eye was still 'normal. In order to give the child its only chance, and to relieve the suffering caused by the glaucomatous eye, I enucleated the globe and also removed a considerable piece of the optic nerve. Under similar conditions I should now make exenteration of the orbit. The operation was followed by marked improvement in tlie child's general condition, but on October 8, about five months after the operation, the mother returned with the child stating that it had vomited frequently during the previous week. Its appetite was poor, but it slept well. No other general symptoms were present. The orbital cavity was filled with a hard mass which did not appear to be attached to the bony walls, but was movable; the new growth appeared to spring from the optic nerve-end, which formed its pedicle. The tumor was removed to the very apex of the orbit and, as surmised, it sprang from that part of the optic nerve which had not been removed at the first operation. As I considered the case beyond hope, I did not wish to cause the child addi- tional and useless suffering by the use of cautery or pastes. The growth promptly recurred and soon developed into a large protruding mass. The child suffered most terrible agonies unless kept under the influence of opiates, 1% grs. of morphia being administered hypodermatically every 4 or 6 hours. The child died on Feb. 26, 1895. (Figs. 1 and 2 are sketches made after death, showing the appearance of the growth.) Postmortem Notes.—Child greatly emaciated. Tumor 12 inches in circumference at the base, projecting from the right orbit about 4 inches. In shape, the tumor had much the ap- pearance of a small cocoanut, and it was of a dark reddish color. The projecting surface was broken down in places and covered with nodules. The growth involved the bony structure and extended from the roots of the hair almost to the alveolar process. The meninges at the base of the right side and a portion of the brain, together with the optic nerve, were exten- sively invaded by the cancerous tissue which was partly ne- crotic. The meninges and brain of the left side, together with the left eye, appeared normal. Microscopic Report of. Globe.—Dr. Louis Strieker reports as follows: Unfortunately, the eye was cut through the equatorial region; hence, no complete sections of the entire globe could be made. Both halves were filled with a new growth, showing on its surface minute red spots—large ves-