. Gynecology : . ndylomata acuminata are sometimes mistaken for cancer. In all caseswhere there is the slightest doubt of the diagnosis a specimen should be removedfrom the growth for microscopic examination. The treatment of cancer of the vulva is immediate and radical operation ifthe case when seen is operable. The operation consists in an extensive vulvec-tomy and dissection of the inguinal lymph-glands of both sides. Most of thesecases come to operation late, and on account of the tendency to early metastasesthe prognosis is, consequently, unfavorable as a rule. If the case is inoperable t
. Gynecology : . ndylomata acuminata are sometimes mistaken for cancer. In all caseswhere there is the slightest doubt of the diagnosis a specimen should be removedfrom the growth for microscopic examination. The treatment of cancer of the vulva is immediate and radical operation ifthe case when seen is operable. The operation consists in an extensive vulvec-tomy and dissection of the inguinal lymph-glands of both sides. Most of thesecases come to operation late, and on account of the tendency to early metastasesthe prognosis is, consequently, unfavorable as a rule. If the case is inoperable thebest hope of relief is from radium. The most valuable recent work on the subject of cancer of the vulva is that embodied in areport by Taussig of 15 cases personally observed. The following are the conclusions reachedby Taussig: Cancer of the vulva is very definitely a disease of old age, the majority of cases occurringafter the age of sixty. The question of age depends, however, on the etiologic factors in the. \N .V. < Fig. 70.—Extensive Cancer of the Vulva Originating in Condylomata Acuminata (after Taussig). case and under certain conditions the disease may appear in young women. Taussigs observa-tions regarding the etiology are especially valuable. Thus in his series of cases he found defi-nite proof that the cancerous growth may originate from the following conditions: trauma,syphilis, condylomata acuminata, kraurosis, leukoplakia, and Pagets disease. The most com-mon predisposing cause is found in the atrophic kraurotic processes that characterize the vulva NEW GROWTHS 291 in old age. Hence the greater incidence of the disease at that time. On the other hand, itmay develop from syphilis or condylomata acuminata, so that it may appear early. Taussigsyoungest cases were twenty-seven and thirty-three. The disease is unusually malignantwhen it occurs in younger women. Taussig suggests that the cessation of the ovarian secretion after the menopause may be apredisposing
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