. Studies on hypertrophy and cancer of the prostate. Fig. 12.— (Case 13.) Schirrous form of adeno-carcinoma. matous elements at a point i cm. above the prostate. The lymphatics,and nerve sheaths are also common avenues for transmission of thedisease, and can often be palpated by rectum as-firm rounded cordsrunning upward and outward beneath the fascia, sometimes completelymasking the seminal vesicle. Several of my specimens show beautifully the intervesicular plateauof infiltration, spoken of before. It is found to be composed micro-scopically of masses of cancer cells in and around the vasa d
. Studies on hypertrophy and cancer of the prostate. Fig. 12.— (Case 13.) Schirrous form of adeno-carcinoma. matous elements at a point i cm. above the prostate. The lymphatics,and nerve sheaths are also common avenues for transmission of thedisease, and can often be palpated by rectum as-firm rounded cordsrunning upward and outward beneath the fascia, sometimes completelymasking the seminal vesicle. Several of my specimens show beautifully the intervesicular plateauof infiltration, spoken of before. It is found to be composed micro-scopically of masses of cancer cells in and around the vasa deferentia An Operation for Cancer of Prostate. 529 and between them and the base of the In these cases theouter layers of the bladder muscle are usually found invaded by narrowprolongations of the disease. In several instances this extended a veryshort distance up the trigone, the bladder being entirely healthy beforethe region of the ureters was reached. The mucosa is rarely broken. Fig. 13.— (Case 64.) A medullary form of carcinoma in which there isvery little stroma and the cancer cells varying in size and shape areloosely arranged. through. In three of these cases the trigone was invaded, once ele-vated, once ulcerated, and once the site of a polypoidtumor. In those cases in which the cystoscope shows slight en-largement of the prostate around the vesical orifice, the disease, if itinvades the bladder at all, attacks the trigone, and if an intravesicaltumor appears it is usually near one of the ureteral orifices. I have 530 Hugh H. Young. seen one such case in which there was a direct continuation of thedisease from a carcinomatous seminal vesicle through the bladder wallinto a small papillary tumor at the right ureteral orifice.
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