Gynecology . g numbers of groupedLanghans and syncytial cells, immediate radical operation is advisable, especi-ally if a hydatidiform mole has preceded. If the initial curetings show con-spicuous, though not numerous, characteristic cell collections, the case is re-garded with grave suspicion, and, if the symptoms have been preceded by amole, radical operation is seriously considered. If, however, the symptoms NEW GROWTHS 321 have followed abortion, it is justifiable to wait to see if further bleeding ensues,which, according to Meyer, will usually take place in two or three weeks if thediseas
Gynecology . g numbers of groupedLanghans and syncytial cells, immediate radical operation is advisable, especi-ally if a hydatidiform mole has preceded. If the initial curetings show con-spicuous, though not numerous, characteristic cell collections, the case is re-garded with grave suspicion, and, if the symptoms have been preceded by amole, radical operation is seriously considered. If, however, the symptoms NEW GROWTHS 321 have followed abortion, it is justifiable to wait to see if further bleeding ensues,which, according to Meyer, will usually take place in two or three weeks if thedisease recurs, though the patient should be kept under strict observation forseveral months, even if her catamenia is normal. If after the careful cureting of a suspicious case, bleeding recurs, and thecuretings again show the same findings, radical operation is indicated. The surprising way in which some seemingly very malignant chorio-epi-theliomata heal spontaneously, even after incomplete operations, is inter-. Fig. 121.— power. At the bottom is the edge of a chorionic villus. The first layer of cells covering itconsists of Langhans cells. Covering this is syncytium and throughout the rest of the drawing aremasses of syncytium lying in coagulated blood. In the lower center is seen the vacuolated appear-ance which syncytium has. estingly explained by Hitschmann and Cristofoletti. These writers observedin their own and reported cases the very common occurrence of parametrialinfiltration. From the study of autopsies and surgical cases they found thatthis infiltration does not consist in an invasion of the parametrial connectivetissue by the cancerous elements, but that the thickening is due to a thrombosisof the parametrial and spermatic veins. This thrombosis of the large pelvic veins may act in two ways: either it maybecome a new focus for metastasis and send off embolic malignant masses to21 322 GYNECOLOGY the lungs, where they may erode the pulmonary ar
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