A Text-book of Diseases of WomenPenrose, Charles B. (Charles Bingham)
Science
A Text-book of Diseases of Women
Penrose, Charles B. (Charles Bingham)
Women -- Diseases
=Fibromata.=--Ovarian fibromata are very rare; they are histologically
similar to fibroid tumors of other parts of the body. They do not
form circumscribed new growths, but affect the whole organ, which
becomes uniformly hypertrophied, preserving its general shape and
anatomical relations. The tumor may contain, between the bundles of
fibrous tissue, small cavities filled with fluid. The growth is usually
intra-peritoneal and has a well-formed pedicle; it may, however, in
exceptional cases be extra-peritoneal and develop between the layers of
the broad ligament. In such a case there is difficulty in determining
whether the fibroid originated in the uterus or in the ovary. Ovarian
fibromata are usually of small size and slow growth. A case has been
reported in which the tumor weighed over 7 pounds.
_Corpora Fibrosa._--A variety of the ovarian fibromata are the corpora
fibrosa, which are due to fibroid degeneration of the corpus luteum.
They are tough, fibrous bodies, about the size of a pea, which are
occasionally found upon the surface of the ovary. It is said that they
may attain the size of a child’s head. They are usually, however, very
small, and have no clinical significance.
=Myomata.=--Ovarian myomata are composed chiefly of unstriped muscular
fiber. They are somewhat more frequent than the pure fibromata. The two
growths may be mixed, forming a fibro-myomatous tumor. The myomatous
tumor may attain the weight of fifteen pounds.
=Sarcomata.=--The majority of solid tumors of the ovary are sarcomatous
in character, and it seems probable that many tumors that are classed
as fibroids or fibro-myomata are in reality ovarian sarcomata. The
growth may be either of the spindle-cell or the round-cell variety.
Occasionally it is an endothelioma, a form of sarcoma developing from
the endothelial cells of the blood- and lymph-vessels.
Sarcoma of the ovary differs from sarcoma in other parts of the body
in the fact that it is very often bilateral. Sutton states that
both ovaries are affected in about 20 per cent. of the cases. Other
observers state that ovarian sarcomata are usually bilateral.
The surface of the tumor is smooth, and the general form and anatomical
relations of the ovary are unaltered. Ovarian sarcomata are usually of
median size, though they may attain enormous proportions and fill the
abdominal cavity.
The tumor is usually of rapid growth; in one case it attained a weight
of ten pounds within a period of six months. The growth is accelerated
by pregnancy. Ascites is commonly present with ovarian sarcoma, and
cachexia may appear rapidly.
Ascites caused by peritoneal irritation may accompany any of the solid
tumors of the ovary, as other kinds of freely movable abdominal tumor.
It is, however, especially characteristic of the ovarian sarcomata, and
is a point of diagnostic importance.
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