File:The diagnosis and treatment of diseases of women (1907) (14598089058).jpg

Identifier: diagnosistreatmecros (find matches)
Title: The diagnosis and treatment of diseases of women
Year: 1907 (1900s)
Authors: Crossen, Harry Sturgeon, 1869-
Subjects: Genital Diseases, Female Gynecology Gynecology Women Generative organs, Female
Publisher: St. Louis : Mosby
Contributing Library: Francis A. Countway Library of Medicine
Digitizing Sponsor: Open Knowledge Commons and Harvard Medical School

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) the disease was confined to the uterus. Wertheim, in 60 operated cases, foundinvolvement of removed glands in 15 percent of early cases and in 31.7 per centof all cases. Schauta made a most thorough autopsy-study of 60 cases, in 40 ofwhich the patients died from the natural effects of the cancer and in 9 from inter-current affections. In 43.3 per cent of the whole series, the glands were entirelyfree of carcinomatous metastases. The lower (removable) glands alone were PATHOLOGY OF CARCINOMA OF CERVIX 665 involved in 13.3 per cent, the upper (not removable) glands alone in 8.3 per centand both lower and upper glands in 35 per cent. Kundradt, in a study of 76 cases operated on by Wertheim, in which the para-metrium was involved on one or both sides, found the glands entirely free ofmetastases in 71 per cent. The glands on one side were involved in 22 per cent,and the glands on both sides were involved in 7 per cent. The glands are rarely involved until the cancer has advanced into the
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Fig. 620. Advanced Adeno-carcinoma of the Cervix Uteri. Notice the involvement of the parametrium.(Kelly—Operative Gynecology.) parametrium. Kundradt, in his analysis of SO cases, found only four in whichthe glands were involved with the parametrium free. Enlargement of the regional glands is very common in the early stage of carci-noma but this enlargement is, as a rule, not due to carcinoma cells but to the in-flammatory hypertrophy that nearly always takes place in the glands draininga region that is subject to severe chronic irritation. In exceptional cases, how- 666 MALIGNANT DISEASE OF THE UTERUS ever, the glands may become infected with carcinoma cells at an early stage ofthe disease. This matter of glandular involvement has a very important bearing on thequestion of operative treatment. In extension by the blood stream, some carcinoma cells penetrate into ablood-vessel, are caught in the current and are carried to distant organs, wherethey lodge and grow and form metastatic

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