. Archives of physical medicine and rehabilitation . lving theupper, outer quadrant of the rightbreast, extending into the upper innerquadrant and adherent to the integu-ment and pectoral muscles. The axillawas filled with a similar mass of aboutthe same size and attached to the bloodvessels. There were a number ofnodules in the supraclavicular case was considered an inoperableone because of the extensive localmetastasis and the fact that the patienthad been aware of the mass for overtwo years. In the following pictures you willnote that the body of the vertebra hasalmost completely
. Archives of physical medicine and rehabilitation . lving theupper, outer quadrant of the rightbreast, extending into the upper innerquadrant and adherent to the integu-ment and pectoral muscles. The axillawas filled with a similar mass of aboutthe same size and attached to the bloodvessels. There were a number ofnodules in the supraclavicular case was considered an inoperableone because of the extensive localmetastasis and the fact that the patienthad been aware of the mass for overtwo years. In the following pictures you willnote that the body of the vertebra hasalmost completely disappeared, whilethe disks are neary intact (Fig. 2).This is quite characteristic of malig-nancies in this region and is in contrastwith tuberculosis of the spine, in whichpei T. HOW ARD PLANK, M. instance the disks as well as the bodyare destroyed. With this additional data I con-sidered the case incurable and treatedit as such. Figure 3, taken a month later, Feb-ruary 22nd, 1922, shows the right halfof the third lumbar broken down, but. Figr. 1—Beginning destruction of tlie tliird 2—Total destruction of tentli ,except disl<. Showing destruction of up-• and lower dorsals and lumbars. with some improvement in the conditionof the ilium at the sacro-iliac 4, taken at this time shows apathological fracture of the right tro-chanter. March 22, 1922, the roentgenogramshowed improvement of the third lum-bar vertebra, also the beginning de-struction of the tenth dorsal, left 4th, 1922, roentgenogramsshowed improvement in the conditioncf the sacro-iliac joint and extensioninto the right trochanter. On May 2, 1922, the picture show-ed the third lumbar vertebra remainingstationary, but showed a complete de-struction of the tenth dorsal May 31st the picture (Fig. 5)showed the beginning destruction of thefourth cervical and second dorsal verte-brae with complete breaking down oft e tenth dorsal vertebra. luly 6, 1922
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