. Clinical gyncology, medical and surgical. loping in thesame manner as in connection with papillomatous cysts. It is not certainwhether these are due to bursting of the cyst or are examples of truemetastasis. The secondary masses present a structure similar to that ofthe parent cyst, containing the same caseous material, but hair has beenfound in them in only a single instance. It should be noted that true dermoid cysts are invariably unilocular,the formation of secondary cysts by proliferation never occurring. If, asrarely happens, separateloculi are found, theirpresence is to be ex-plained
. Clinical gyncology, medical and surgical. loping in thesame manner as in connection with papillomatous cysts. It is not certainwhether these are due to bursting of the cyst or are examples of truemetastasis. The secondary masses present a structure similar to that ofthe parent cyst, containing the same caseous material, but hair has beenfound in them in only a single instance. It should be noted that true dermoid cysts are invariably unilocular,the formation of secondary cysts by proliferation never occurring. If, asrarely happens, separateloculi are found, theirpresence is to be ex-plained rather by thecoalescence of separateadjacent cysts (three orfour of which may de-velop independently inthe same ovary) thanby the actual growthof septa within a uni-locular cyst, as Taitsuggests. So-callednmltilocular dermoids(Fig. 17) are not, asthe name would seem toimply, pure dermoidscontaining several compartments, but are ordinary proliferating cysts, oneor more loculi of which present the ordinary structure of a dermoid, as Fio. Small multilocular dermoid cyst. (Museum of the College ofPhysicians and Surgeons.) G38 NEOrLASMS OF THE OVARIES, TUBES, AND BROAD LIGAMENTS. regards the presence of skin, hair, bone, etc. These growths, which arenot uncommon, possess considerable interest for the surgeon as well as forthe pathologist, since the presence of the dermoid element may modify theprognosis of an otherwise simple neoplasm by introducing certain compli-cations (peritonitis, suppuration, perforation, etc.) peculiar to the latter classof tumors. The Pedicle.—In order to understand the formation of this structurethe reader must familiarize himself with the normal relations of the Ovaryto the Fallopian tube and mesovarium. According as a tumor arises fromthe parenchyma or from the hilum, it will tend to grow upward into theabdominal cavity or between the folds of the broad ligament; in otherwords, its development will be respectively intra-peritoneal or extra-peri-ton
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