A case of cystic interstitial uterine fibroid appearing papillomatous / by Alban Doran.

  • Doran, Alban H. G. (Alban Henry Griffiths), 1849-1927.
Date:
1908
Catalogue details

Licence: In copyright

Credit: A case of cystic interstitial uterine fibroid appearing papillomatous / 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.

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    The curette had been applied three months previously, hut the menorrhagia continued. I kept the patient at rest for a week, and operated on July 8th, assisted hy Dr. Clifford White, Dr. Belfrage administering the antestlietic; the tumour had sunk considerably downwards since I first examined it, half of its hulk occupying the pelvis. The abdominal walls were very thick with fat. The uterus, which seemed uniformly enlarged, was amputated above the cervix, both appendages being removed as well. As I cut through the uterus, about four ounces of clear serum escaped. At first I thought that I had laid open a gravid uterus, as some solid growth, like foetal membranes, floated in the serum. On further inspection I found that the solid growth had all the appearances of a papilloma such as develops along the line of Gartner’s duct, very pale pink in colour. It sprang from the inner wall of a cyst which lay entirely in the substance of the posterior wall of the uterus and constituted the tumour. The cyst projected into the uterine cavity, which in consequence was much dilated, but showed no visible signs of endometritis, the mucous membrane being very smooth and pale, nor did I find any pent-up discharge or coagula. The tissues on the cut surface of the uterine stump were free from new growths. I trimmed the stump lest any of the cyst wall might be left behind. The stump was treated in the usual manner, an anterior peritoneal flap being sewn over its raw surface. I saw the patient on November 17th. There had been no period since the operation; in August she was troubled with frequent flushings, which had subsided but occasionally woke her up at night. The abdominal wound had cicatrized well; the stump of the cervix had become smaller, and was quite movable. The patient was troubled with muscular rheumatism during the close weather in October, but declared that she was entirely free from pain or discomfort in the pelvic region or abdomen. Description of the Specimen. I cut away a piece of the intra- cystic growth and sent it to Dr. G. L. Eastes’ Laboratories of Pathology and Public Health, where sections were prepared for me. The uterus was sent to the Museum of the Royal College of Surgeons. I must observe that the parts removed shrank considerably before I was able to examine them at the conclusion of the operation, much serum running away out of the cyst. Already, as above related, four ounces escaped when the knife passed through the uterus. The preservative media and the freer opening of the cyst to expose its contents have caused further shrinkage. Hence it is impossible for me to record accurate measurements. The cyst cavity before it was laid open was about three times as capacious as it is in the mounted specimen, which will now be described.