[Illustration: FIG. 167.--An oöphoritic glandular cyst. The section shows the remains of an atrophied septum, a number of follicular cysts in the wall, and to the right a group of mucous retention-cysts.] As glandular cysts of the ovary originate in the free border of the gland, they are in the great majority of cases intra-peritoneal in their growth. They grow into the peritoneal or the abdominal cavity; they do not push aside layers of peritoneum, like the cysts that originate between the folds of the broad ligament, and which are extra-peritoneal in their development. Very rarely glandular cysts of the ovary have been found that grew between the layers of the broad ligament and were extra-peritoneal in development. It may be that in such cases the ovary itself had occupied an abnormal position. The shape of the ovary is very early destroyed by a glandular cyst. The ovarian tissue is incorporated with, and is spread throughout the cyst-wall. In small tumors the remains of the hilum may be found at the pedicle. In no case is the body of the ovary discoverable as a distinct structure lying upon the surface of the cyst. The _pedicle_ of the cyst is composed of the ovarian ligament, the upper portion of the broad ligament, and the Fallopian tube. These structures are all more or less thickened and lengthened as a result of the traction and of the altered nutrition produced by the growing cyst. The vessels of the pedicle that are derived from the ovarian and uterine arteries are of various size. The arteries rarely exceed the size of the radial artery. Glandular cysts are of unlimited growth. They increase in size until they destroy the woman by direct pressure. They literally crowd her out of existence. The size they may attain is determined only by the powers of resistance of the woman and the distensibility of the abdominal walls. Glandular cysts have been removed that weighed 200 pounds. The shape of the glandular cyst is approximately spherical. It is often distorted by pressure, and portions of the tumor may represent a mould of parts of the pelvic or posterior abdominal walls. The glandular cyst is usually unilateral. The proportion of cases in which both ovaries are affected seems to be about 4 per cent. In some cases, when both ovaries are affected, the cysts may become fused, so that a single tumor is formed, attached by two distinct pedicles. Operation in such cases is often very embarrassing. The glandular cyst is the most common form of ovarian tumor. It may occur at any time of life from childhood to old age. It is most common between the ages of twenty and fifty. =Dermoid Cysts.=--A dermoid cyst of the ovary is characterized by the presence of skin and cutaneous appendages. Dermoid cysts are found in various parts of the body, but they occur most frequently in the ovary. Of 188 dermoid cysts reported by Lebert, 129 occurred in the ovary. Dermoid cysts comprise from 4 to 5 per cent. of all ovarian tumors.