Gynaecology for students and practitioners . nd Sutton {seeFig. 249), in which considerable difficulty will be found in decidingwhether the amount of penetration of the uterine wall by the gland-tubules constitutes malignancy or not. Curettings obtained from repeated recurrences in some cases haveshown a benign structure, but upon removal of the uterus its wallshave been found to be invaded by a growth indistinguishable froma tubular carcinoma (Targett). 500 GYNECOLOGY Prognosis. From the above facts it will be seen that a villouspapilloma of the uterus, although benign, possesses the power of
Gynaecology for students and practitioners . nd Sutton {seeFig. 249), in which considerable difficulty will be found in decidingwhether the amount of penetration of the uterine wall by the gland-tubules constitutes malignancy or not. Curettings obtained from repeated recurrences in some cases haveshown a benign structure, but upon removal of the uterus its wallshave been found to be invaded by a growth indistinguishable froma tubular carcinoma (Targett). 500 GYNECOLOGY Prognosis. From the above facts it will be seen that a villouspapilloma of the uterus, although benign, possesses the power ofinfiltration and invasion of the muscular walls of the uterus ; in otherwords, it must be regarded as a clinically malignant growth. Treatment. If curettings obtained from the uterus of an elderlysubject reveal the presence of a histologically benign papilhferousadenoma the case should be treated by hysterectomy. Simple Adenoma of the Cervix. True adenoma is an extremelyrare condition in the cervix. As will be shown later, when the columnar. Fig. 251. Simple Adenoma oe the Cervix. From a sterile woman aged thirty-six years. epithelium of the cervical glands proliferates, the tendency usuallyis towards the development of cell-metaplasia and malignancy, theresulting neoplasm being a squamous-celled carcinoma. Less fre-quently a true adeno-carcinoma of tubular type develops, in whicha marked resemblance to gland-tissue is produced. Rarest of all isthe formation of a simple adenoma possessing an essentially benignstructure. The only case of which we have had experience was thatof a woman aged thirty-six years, who had been married eleven yearsand was sterile. She had suffered from profuse leucorrhoea fromchildhood. Other symptoms were haemorrhage on coitus, menorrhagia,metrorrhagia, and a constant dragging pain. On examination the SARCOMA OF THE UTERUS 501 surface-epithelium of the vaginal cervix was mostly replaced by apapillary, hsemorrhagic growth, which was deeply fissured as i
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