File:The practice of surgery (1910) (14592430889).jpg

Identifier: practiceofsurger00mumf (find matches)
Title: The practice of surgery
Year: 1910 (1910s)
Authors: Mumford, James Gregory, 1863-1914
Subjects: Surgery
Publisher: Philadelphia and London, W. B. Saunders company
Contributing Library: Columbia University Libraries
Digitizing Sponsor: Open Knowledge Commons

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rgin ofthe ulcer is hard, irregular, and elevated. The base is rough and bleedseasily. The process may destroy the cervix, and when situated in thecervix, may extend variously and involve the vaginal vault, especiallyin front and at the sides; the broad ligaments, rarely the uterine append-ages, the ureters, the bladder, the urethra, and pelvic bones; the fundus,the iliac lymph-nodes, after having invaded the broad ligaments;this delay, says Dudley, is because the squamous cancer-cells are too TUMORS OF THE UTERUS 307 large to pass through the lymph radicles of the cervix, but not toohirge to traverse the lymph-vessels of the ligaments. Furthermore,the kidneys may be involved in nephritis, hydronephrosis, or pyeloneph-rosis, and dilatation of the ureters is common. Metastatic cancer maybe found in distant organs. Cancer of the body of the uterus may extend in much the samefashion, but it implicates the lumbar lymph-nodes and abdominalorgans more quickly than does cancer of the cervix.
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^_ _sL.l Fig. 189.—Inoperable epithelioma of the cervix in which the chief involvementis at the internal os, where the uterus is perforated. In the mucous membrane of thefundus a few epithelial nests are found lying between normal uterine glands (naturalsize) (Kelly). The causation of cancer of the uterus is as undetermined, withthe exception of one factor, as is the causation of cancer elsewhere. Thatone factor is laceration of the cervix from labor.^ This is an extremelyimportant matter, and, in addition to others, Craig has pointed outthat among the victims of uterine cancer it is almost impossible to findone who has suffered from a cervical laceration which has been earlyand properly repaired. It is now accepted as a fact among observant 11 have referred already to the possibility of the malignant degeneration ofmyomata. 2 Daniel H. Craig, New York Med. Jour., July S, 1905. 308 FEMALE ORGANS OF GENERATION practitioners that laceration of the cervix is a common cause of uterineca

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