Primary cancer of the Fallopian tube / by Alban Doran.

  • Doran, Alban H. G. (Alban Henry Griffiths), 1849-1927.
Date:
1888
Catalogue details

Licence: Public Domain Mark

Credit: Primary cancer of the Fallopian tube / 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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    found occasional clusters of small spindle-cells (fig. 4, 6), whicli possibly represent the spindle-celled tissue of medullary carcinoma figured and described in S. W. G-ross’s ‘ Practical Treatise on Tumours of the Mammary Gland,’ fig. 23, p. 134 in the 1880 edition. I have above descilbed what I observed, and I do not think that there can be much doubt that the morbid growth in this case was cancer and not sarcoma. The clinical and pathological evidence tends to prove that the tube was the primary seat of disease. Considering that there was vaginal dischai'ge for three years, much broken-down material escaping till the date of operation, that the uterus was scraped with a curette, and that fourteen months later it was found free from disease, whilst the tube contained not only a new growth but also fluid and broken-down matter resembling the discharge, that new growth was certainly tubal and not uterine. The ovary was cancerous, but evidence was against its being the original seat of disease. The history of the discharge favoured the view that the tube had been involved for a long time. The growths within the tube were well developed, the tube being consequently much enlarged. On the other hand, the ovary, although entirely con- verted into a mass of new growth, was still small, as though but recently invaded. Had the tumour detected by Dr. Routh early in 1887 been ovarian, the ovary would have formed a very large mass of malignant disease by March, 1888, for solid mahgnant ovarian tumours grow very quickly. The tube is ever slow to become invaded in primary cancer or sarcoma of the ovary, and when attacked it is usually the serous coat which is first involved, so that the surface of the tube a^^pears studded with little white knobs. This I have observed several times. Winckel figures a characteristic specimen in his handbook. In the largest true cancerous tumour which I ever examined, the tube was deeply sunk between two lobes of the tumour, but quite uninvolved in the disease. Schroder noted that the tube in carcinoma of the ovary remains for a long time intact. I can find but two undoubted cases of primary malignant disease of the Fallopian tube recorded in recent medical literature, and in one the growth was described as sarcoma. Dr. Martin, of Berlin, informed me in January that he had operated on two cases of carcinoma of the tube, and had given the specimens to his assistant.