Primary cancer of the Fallopian tube is almost invariably unilateral and its association with fibroids of the uterus is unusual. It is necessary for the surgeon to remember that a cancerous Fallopian tube may lead to complications with an ovarian cyst. Our knowledge of primary cancer of the Fallopian tube has grown up within the last twenty years, and some of the recorded cases puzzled the reporters because the disease was associated with a cyst, sometimes of a large size. In Fig. 5 I have represented an instructive specimen, which is an ovarian cyst complicated with primary cancer of the corresponding Fallopian tube. In this instance the cyst was as big as a cocoa-nut and multilocular: the ampulla of the tube is stuffed with cancer, but the ostium is patent and a ‘stream’ of cancerous material has flowed over the wall of the cyst. In addition, the cancerous material has infiltrated the wall of the ovarian cyst. The patient recovered from the operation, but a year later she had an extensive recurrence. The primary mortality of simple oöphorectomy, or oöphorectomy combined with hysterectomy for primary cancer of the Fallopian tube, is about 5%, and this is low in comparison with abdominal hysterectomy for cancer of the cervix; it is due to the fact that tubal cancer does not so readily become septic (Doran). REFERENCES DORAN, A. A table of over fifty complete cases of Primary Cancer of the Fallopian Tube. _Journal of Obst. and Gyn. of the British Empire_, 1904, vi. 285. BLAND-SUTTON, J. Tumours Innocent and Malignant, 4th Ed., 1906, 400. ---- On Cancer of the Ovary, _Brit. Med. Journal_, 1908, i. 5. CHAPTER IV OPERATIONS FOR EXTRA-UTERINE GESTATION The systematic surgical treatment of extra-uterine gestation we owe to the genius of Lawson Tait. His first operation for this condition was performed in 1883. Tait wrote that he conceived and carried out this operation in obedience to the canon of surgery relating to the arrest of hæmorrhage, and which is valid in other regions of the body. Many surgeons (even a butcher) had removed living, dead, and putrescent extra-uterine fœtuses from the abdomen of living women, but Tait was the first to attempt the operation in those early stages of tubal gestation in which the tube bursts, or expels (tubal abortion) the products of conception through the cœlomic ostium or a rent in the gestation-sac, into the abdominal cavity, accompanied by an escape of blood so abundant that it may destroy life in a few hours. =Indications.= The operative treatment of extra-uterine gestation depends mainly on the stage at which it is required. When a gravid tube is detected before rupture, the operation is practically that of oöphorectomy: and is simple and safe.