. Journal of the New York Institute of Stomatology, American Academy of Dental Science, Harvard Odontological Society and the Metropolitan District (Mas . out. As growth advances the lx>nycovering becomes progressively thinned, until finally an egg-shellcrepitus can be obtained. When the tumor penetrates the bone,-row tli becomes much more rapid. After this the tumor tissueitself ran be palpated. It may be firm or soft, but usually is of THE JOURNAL. 243 irregular consistency. Cysts at times form and give rise to thelarge cysto-sarcomata with fluctuating areas. The sarcomata of the maxillae
. Journal of the New York Institute of Stomatology, American Academy of Dental Science, Harvard Odontological Society and the Metropolitan District (Mas . out. As growth advances the lx>nycovering becomes progressively thinned, until finally an egg-shellcrepitus can be obtained. When the tumor penetrates the bone,-row tli becomes much more rapid. After this the tumor tissueitself ran be palpated. It may be firm or soft, but usually is of THE JOURNAL. 243 irregular consistency. Cysts at times form and give rise to thelarge cysto-sarcomata with fluctuating areas. The sarcomata of the maxillae occur in relatively young in-dividuals, that is, between the ages of fifteen and the tumor is central the early objective symptoms do notdiffer from those of other intra-osseous growths of the jaw ; whenperipheral, one can recognize at an early stage the consistencyand character of the tumor. Ultimately, the sarcomata, if left to themselves, becomeenormous, and in their growth lead to ulceration and extensiveinvolvment of the adjacent parts. Enlargement of the cervicallymph nodes is rare and when it occurs is often due to a super-. FlG. n. Epuli?. Microscopically, a Giant-celled Sarcoma. (After Miciulicz.) imposed inflammatory process. Recurrences, both local and gen-eral, are frequent after removal. It is evident, then, that these sarcomata are malignantgrowths. The degree of malignancy is indicated by variousfactors: the size, variety, rapidity of growth, extent of involv-ment of adjacent tissues, and ulceration. The giant celledvariety is relatively benign in character and slow in growth ; itrarely recurs after radical removal, and rarely becomes general-ized. The round and spindle celled varieties, however, are moremalignant and, according to Estlander, the average duration ofthese without intervention is less than one year. With the sarcomata must be considered the so-called epulis( Fig. XI). The term epulis, which means literally upon the 244 THE JOURXAL
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