File:The pathology and surgical treatment of tumors (1895) (14775265814).jpg

Identifier: pathologysurgica1895senn (find matches)
Title: The pathology and surgical treatment of tumors
Year: 1895 (1890s)
Authors: Senn, Nicholas, 1844-1908
Subjects: Neoplasms Neoplasms Cancer Cancer
Publisher: Philadelphia : Saunders
Contributing Library: Francis A. Countway Library of Medicine
Digitizing Sponsor: Open Knowledge Commons and Harvard Medical School

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Fig. 253.—Primary carcinom.i of the urethra in the femal(after Winckcl) : a, urethra ; /, fundus of hladder. CARCINOMA. 369 Carcinoma of the bladder frequently selects that part of the bladder-wall corresponding to the insertion of the ureters. Secondary carci-noma of the bladder from extension of the tumor from the prostateinvades the base of the bladder; after the growth has reached thevesical mucous membrane it becomes diffuse, often blocking the orificeof the urethra with masses of tumor-tissue. After ulceration has set inshreds of carcinomatous tissue are often voided with the urine. Theulceration usually extends in the course of time over the entire surfaceof the tumor (Fig. 254).
Text Appearing After Image:
Fig. 254.—Papillary carcinoma of the anterior wall of the bladder in the female (after Winckel): a, papillarycarcinoma ; b, orifices of ureters ; c, urethra. The most prominent symptoms of carcinoma of the bladder arehemorrhage, frequent desire to urinate, and great pain after evacuationof the bladder. Microscopical examination of fragments of tissuevoided with the urine or removed in the eye of the catheter will oftenprove of great value in making a positive diagnosis. In women anincision through the vesico-vaginal septum, and in men a suprapubiccystotomy, will enable the surgeon to make a positive diagnosis, andwill also afford relief by establishing a permanent fistula. If the car-cinoma is superficial, removal after opening the bladder should beattempted. If the tumor involves the anterior wall or fundus of thebladder, the indication is for a radical operation by excision of the entirethickness of the bladder-wall beyond the limits of the tumor throughan abdominal incision. If t

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