. Annals of surgery . fungating edge. It iscircumscribed by an indistinct capsule. No portions of the testicle are visible inthe single gross section. On microscopic examination the structure is composedof large and small groups of large polyhedral and spindle cells of indifferentembryonal type, consistmg chiefly of hyperchromatic nuclei. These cell groups 380 MALIGNANT DISEASE OF THE TESTIS grade off into an abundant mucinous tissue of myomatous type and every grada-tion from polyhedral to star-shaped cells may be followed. Some cell clusterssurround blood-vessels, which are not numerous. The
. Annals of surgery . fungating edge. It iscircumscribed by an indistinct capsule. No portions of the testicle are visible inthe single gross section. On microscopic examination the structure is composedof large and small groups of large polyhedral and spindle cells of indifferentembryonal type, consistmg chiefly of hyperchromatic nuclei. These cell groups 380 MALIGNANT DISEASE OF THE TESTIS grade off into an abundant mucinous tissue of myomatous type and every grada-tion from polyhedral to star-shaped cells may be followed. Some cell clusterssurround blood-vessels, which are not numerous. There are scanty small pointsof necrosis. The diagnosis is embryonal carcinoma of testis, with transition topseudosarcomatous structure. Doctor Ewing, recently reviewing this case stated,that the diagnosis embryonal carcinoma, given in his report, was an error, andthat he regarded this as one of the verj- few cases in which he would make adefinite diagnosis of sarcoma of the spindle- and round-celled type. (Fig. i.) . V. •? T. Pig. I.—Three times recurrent, round and spindle-celled sarcoma of the testes, in achild twenty months old. Toxins given after last operation. Patient in good health overfive years later. (Case XI in table.) The toxins were given for about two weeks and later continued at home by thefamily physician, to whom it was suggested that the treatment be kept up for aconsiderable period. At the end of a few months, however, the patient was so wellthat the treatment was discontinued. About a year and a half later, another nodulethe size of a pea, appeared in the neighborhood of the scar. This was removed andpronounced by Doctor Ewing to be of the same structure as the original toxins were then resumed and kept up for an even longer period than \t the present time, five years after the last operation, the patient is in excellentcondition with no trace of a recurrence. In this case, in view of the very rapidrecurrence after two operations alone, I
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Keywords: ., bookcentury1800, bookdecade1880, booksubjectsurgery, bookyear1885
