. Tumours, innocent and malignant; their clinical characters and appropriate treatment. Fig. 28.—Coronal section of the upper end of the tibia showing a myelomain the outer tuberosity. (From a woman of 25 years.) site, but in the fernur it is the condyloid end. A myelomais very rare in the patella (Fig. 33). In the mandible myelomas affect the body of the bone,but in the maxilla they prefer the alveolar border, and maysometimes remain in the early stage restricted to thepremaxilla. Clinical characters.—These are, as a rule, sufficientlycharacteristic to ensure accurate diagnosis. The patients
. Tumours, innocent and malignant; their clinical characters and appropriate treatment. Fig. 28.—Coronal section of the upper end of the tibia showing a myelomain the outer tuberosity. (From a woman of 25 years.) site, but in the fernur it is the condyloid end. A myelomais very rare in the patella (Fig. 33). In the mandible myelomas affect the body of the bone,but in the maxilla they prefer the alveolar border, and maysometimes remain in the early stage restricted to thepremaxilla. Clinical characters.—These are, as a rule, sufficientlycharacteristic to ensure accurate diagnosis. The patients are 48 TUMOURS young, rarely above 25 years of age; the tumour grows quiteslowly, expands tlie bone, and thins the osseous capsule whileexpanding it until the bony shell is so thin that it crepitateswhen pressed by the finger (egg-shell crackling). Here andthere the myelomatous tissue perforates the capsule andmarkedly pulsates synchronously with the cardiac do not infect lymph-glands, nor Fig. 29.—Coronal section of the lowerends of the tibia and fibula, withthe astragalus; a myeloma occupiesthe lower end of the tibia. (Froma woman aged 23 years.) Fig. 30.—A myeloma of the upper endof the radius ; from a man of 28 years.(Museum, St. Thomass Sosjntal.) Treatment.—When the patient comes under observation be-fore the tumour has perforated its capsule, it may be thoroughlyextirpated without fear of recurrence. The manner ofthorough extirpation varies with the situation of the tumour. In the upper limb, the lower extremities of the radius andulna have been excised for myeloma, leaving an extremelyuseful hand. It is an important fact to remember that thelower third of the ulna may be excised alone, but whenthe radius is the affected bone it is an advantage to remove MYELOMAS 49 the corresponding section of the uhia. The upper third of thehumerus, the inner half and the outer half of the clavicle havebeen resected for myeloma
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Keywords: ., bookcentury1900, bookdecade1910, booksubjectneoplasms, bookyear19
