Chicago medical journal and examiner . from the broadand round ligaments of the uterus; and in front and beneathVol. XXXIV. —No. 2. 1 98 CHICAGO MEDICAL JOURNAL AND EXAMINER. what we at first supposed to be visceral and parietal adhesions,but what proved to be simply the reflections of the peritoneumto the bladder and pelvic parietes. In short, we had, insteadof an ovarian cyst, not simply a subserous fibroid attached tothe fundus of the uterus, but a fluctuating tumor involvingthe uterus itself; the broad ligaments with their inclosuresextending from the fundus of the mass. The whole was easi
Chicago medical journal and examiner . from the broadand round ligaments of the uterus; and in front and beneathVol. XXXIV. —No. 2. 1 98 CHICAGO MEDICAL JOURNAL AND EXAMINER. what we at first supposed to be visceral and parietal adhesions,but what proved to be simply the reflections of the peritoneumto the bladder and pelvic parietes. In short, we had, insteadof an ovarian cyst, not simply a subserous fibroid attached tothe fundus of the uterus, but a fluctuating tumor involvingthe uterus itself; the broad ligaments with their inclosuresextending from the fundus of the mass. The whole was easilyremoved by dividing the attachments to the inguinal regions,the peritoneum at its reflections from the tumor and thevagina just below the os uteri. The weight of the mass was14^ pounds. The appearance of the tumor: 1st, On its anterior aspectand without disection. 2d, On the left side with the uterinecavity laid open; and, 3d, With the mass laid open frombehind showing the cavity of the large cyst, is shown in thecuts 1, 2 and, Figure 1. Anterior aspect op Tumor — showing uterine appendages in theirrelation to the Mass, and the os and cervix uteri. The interest in this case is not alone on account of therarity of this form of tumor, but especially because of the UTERINE FIBRO-C YSTOMA. 90 liability of confounding, in diagnosis, this with ovarian cys-toma. The rules laid down by Wells, as a guide in the differentialdiagnosis between uterine and ovarian tumors, do not hold inmany particulars when the uterine tumor is of the cysticvariety, and especially when in case of a monocyst of large size. The following points from what of the history of the case Iwas able to obtain, and from examination before and afterdeath, are given in connection with Peaslees table of differen-tial diagnosis between uterine fibro-cystorna and ovarian cysts.
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Keywords: ., bookcentury1800, bookdecade1870, booksubjectmedicine, bookyear187
