Sequel to the case of primary cancer of the Fallopian tube reported in the thirty-ninth volume of the Society's Transactions / by Alban Doran.

  • Doran, Alban H. G. (Alban Henry Griffiths), 1849-1927.
Date:
1889
Catalogue details

Licence: Public Domain Mark

Credit: Sequel to the case of primary cancer of the Fallopian tube reported in the thirty-ninth volume of the Society's Transactions / by Alban Doran. 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.

    3/8 (page 3)
    attachment to the stump, forming a pouch in front of the uterus, in which lay part of the left round ligament. These bands seemed to represent recent peritonitis ; none passed from the right stump to the uterus or bladder. The cervix was thick and soft. The os externum was circular and entire. In the vaginal portion of the cervix I found no trace of malignant ulcer, solid tumour or loss of tissue, but the surface was studded with minute secondary deposits. The walls of the bladder were much thickened, and its cavity capacious. The mucous membrane was deeply injected; on its surface were streaks of dark congested tissue and abundant secondary deposits forming white specks slightly elevated. Much fat lay in the subserous tissue, especially in front of the bladder and on the left side of the pelvis towards Douglas’s pouch. Similar deposits of fat are frequently seen in cases of rectal cancer. A spherical mass of new growth, three quarters of an inch in diameter, lay to the right of the cervix in Douglas’s pouch. It evidently represented the portion of the cancerous right ovary which the operator was obliged to leave behind (loc. cit., p. 209). Mr. Thornton could not have left much of the diseased ovary in the pelvis, for the mass was not an inch in diameter at death, nearly eleven months after the operation. Hence the entire cancerous ovary must have been very small when Mr. Thornton operated. I may fairly urge that this fact strongly favours my original view, considering the large size of the tubal growth, that the ovary was not the seat bf the primary disease. The stump of the right appendages (which included the cancerous tube) had completely cicatrised, and was not the seat of malignant deposit.1 On laying it open no trace of the ligature could be found. The portion of the canal of the tube which traverses the uterine walls was converted into an oval, perfectly closed cystic cavity, half an inch in long diameter. It was filled with grumous, partially decolourised clot, and its mucous lining was thickened, but free from any malignant growths. The uterine end of the amputated tube contained similar clot, and was also free from cancer (loc. cit., p. 210, and plate xiii, fig. 1, b). The uterine orifice of the tube was absolutely closed. 1 See Mr. Thornton’s note of the operation quoted in my original paper. I there observed that the diseased tissue, which he described, was probably de- colourised clot.