. The diagnosis and treatment of diseases of women. form of adeno-carcinoma in which thepenetrating cells preserve, to a marked extent, the glandular arrangement. The infiltration in adeno-carcinoma, being situated in the interior of thecervix, is not appreciated by the examining finger until a considerable mass hasformed. The cUsease pursues much the same general course as described for epithel-ioma, the carcinoma cells penetrating deeper and deeper into the cervix and intothe surrounding connective tissue (Fig. 620). PATHOLOGY OF CARCINOMA OF CERVIX 663 Endothelioma is a rare form of maligna
. The diagnosis and treatment of diseases of women. form of adeno-carcinoma in which thepenetrating cells preserve, to a marked extent, the glandular arrangement. The infiltration in adeno-carcinoma, being situated in the interior of thecervix, is not appreciated by the examining finger until a considerable mass hasformed. The cUsease pursues much the same general course as described for epithel-ioma, the carcinoma cells penetrating deeper and deeper into the cervix and intothe surrounding connective tissue (Fig. 620). PATHOLOGY OF CARCINOMA OF CERVIX 663 Endothelioma is a rare form of malignant disease of the cervix in which micro-scopic examination sliows spaces Hned with prohferating cells resembling endo-thelium. Its exact nature and origin have not been determined—in fact, it is stilluncertain whether it is an epithelial growth (carcinoma) or a connective-tissuegrowth (sarcoma). Modes of extension. Carcinoma of the cervix extends in four ways—by con-tinuity of tissue, by the lymphatics, by the blood-stream and by Fig. 618. An Epithelioma of the Cervix Uteri, advanced to stage ofthe destruction of the cervix. (Cullen—Cancer of the Uterus.) Extension by continuity of tissue is the principal method and, aside from ex-ceptional cases, the only method in the earlier stages of the growth. In this methodof extension, the carcinoma cells grow into the tissues against which they differs markedly from the way in which a non-malignant tumor fibromyoma as it grows, pushes aside the adjacent tissues, but a malignanttumor as it grows penetrates the adjacent tissues and destroys them. It is this insidious involvement of contiguous tissues that makes many cervicalcarcinomata inoperable when first seen. It is this same gradual extension outward 664 MALIGNANT DISEASE OF THE UTERUS by continuity of tissue that later causes the patient most of her suffering andthat in most cases causes her death, by involving the uterus or bladder or rectum.
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