. Clinical gyncology, medical and surgical. AND MIXED GROWTHS. These tumors have their origin ordinarily in the labium majus,although they are not limited to this part, being sometimes situated on thenymphse. They are composed mainly of fibrous connective tissue, withsome muscular structure; the latter is presumably derived from fibres ofthe round ligament or the numerous muscle-bundles of the derma. Inappearance they do not differ from the lipomata previously described. Myxomata occur occasionally in the same locality, and are so designatedon account of the preponderance of myxomatous tissue.


. Clinical gyncology, medical and surgical. AND MIXED GROWTHS. These tumors have their origin ordinarily in the labium majus,although they are not limited to this part, being sometimes situated on thenymphse. They are composed mainly of fibrous connective tissue, withsome muscular structure; the latter is presumably derived from fibres ofthe round ligament or the numerous muscle-bundles of the derma. Inappearance they do not differ from the lipomata previously described. Myxomata occur occasionally in the same locality, and are so designatedon account of the preponderance of myxomatous tissue. Mixed varieties occur, as myxolipoma and myo-fibroma. These tumors have a tendency to increase slightly in size during preg- 34 530 NEOPLASMS OF THE VULVA AND VAGINA. nancy and menstruation, but usually diminish to their former volumeafter the subsidence of these processes, unless, as occasionally happens, ahemorrhage takes place into their interior, when the increase in size issudden and permanent; otherwise their growth is slow. Fig. Fibroid polypus of vulva. Inasmuch as their tendency is to grow in the direction of least resistance,it is not unusual for them to become pedunculated; they sometimes reachas low as the knees: under such circumstances it is not uncommon forinflammation and ulceration of the surfaces to occur, as the result offriction. They are benign, and their treatment is surgical, being the sameas for lipoma. The removal of the growths, if done with ordinary care,is devoid of danger. ELEPHANTIASIS The disease may affect the entire vulva, or only a part of it: if thegrowth is limited, which is usually the case, its location is generally the labiamajora, next the clitoris; the labia minora are rarely affected. In ourclimate we seldom see the affection, but in the tropics it is not these tumors attain an enormous size, reaching in weight fromtwenty to thirty or more pounds, and extending down to the knees. As arule, they are atta


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