. Tumours, innocent and malignant; their clinical characters and appropriate treatment. lyin connexion with the capside, and then gradually invadesthe true tissue of the kidney. The relation of renal sar-comas to the capsule is of some importance, becausesimilar tumours arise in the connective tissue in which thekidney is embedded ; these are perirenal sarcomas, and, asfar as my observations go, this is a more frequent positionfor them than those which we term renal sarcomas. Acareful comparison of these tumours leads me to believethat, in the adult, sarcomas of the type represented in 102 OON
. Tumours, innocent and malignant; their clinical characters and appropriate treatment. lyin connexion with the capside, and then gradually invadesthe true tissue of the kidney. The relation of renal sar-comas to the capsule is of some importance, becausesimilar tumours arise in the connective tissue in which thekidney is embedded ; these are perirenal sarcomas, and, asfar as my observations go, this is a more frequent positionfor them than those which we term renal sarcomas. Acareful comparison of these tumours leads me to believethat, in the adult, sarcomas of the type represented in 102 OONJ^EGTIVE-ttSSU:^ TUMOtM Fig. 60 have their origin in the renal capsule, whereas thesarcoma of childhood arises, as already pointed out, in theconnective tissue of the renal sinus. This is a subject ofsome interest, because a critical comparison of the modeof origin of sarcomas in viscera similar to the kidney, spleen, thyroid gland, and prostate, shows that suchtumours are not only uncommon, but are often closelyconnected with the connective-tissue investments of Fig. 60.—A kidney in section with a sarcoma invading its cortex. From a man51 years of age. {Museum, 3fiddlesex Hospital.) Treatment.—The only available treatment for renal sar-coma is early excision of the affected organ. This is rarely ofmuch service. The mortality of the operation is now verysmall, but recurrence usually takes place within a year. A new interest was given to malignant tumours of thekidney when Grawitz stated that many of them occurringin adults exhibited the structure of the zona fasciculataof the adrenal. Grawitz further suggested that thesetumours, now known as hypernephromas, probably arose indetached (ectopic) pieces of the adrenals (accessary adrenals). It has long been known that accessary adrenals are found SARCOMAS OF GLANDULAR ORGANS 103 beneath the capsule of the kidney (Fig. 61), as well as on theunder surface of the liver; they are also found in the retro-periton
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Keywords: ., bookcentury1900, bookdecade1910, booksubjectneoplasms, bookyear19
