A system of surgery . in the mediastinum,illustrate the disastrouseffects of infiltration (). Dissemination. —Sar-comata are liable to re-produce themselves indistant parts. The mostusual organ in which tofind secondary depositsis the lung (Fig. 117),unless the primarytumour is situated in theterritory of the portalcirculation, then they willbe found in the liver. Invery malignant sarco-mata, especially the round-celled species, secondarydeposits may form inevery organ of the are always identi-cal in structure with the primary tumour. The relation to veins.—It has long been re
A system of surgery . in the mediastinum,illustrate the disastrouseffects of infiltration (). Dissemination. —Sar-comata are liable to re-produce themselves indistant parts. The mostusual organ in which tofind secondary depositsis the lung (Fig. 117),unless the primarytumour is situated in theterritory of the portalcirculation, then they willbe found in the liver. Invery malignant sarco-mata, especially the round-celled species, secondarydeposits may form inevery organ of the are always identi-cal in structure with the primary tumour. The relation to veins.—It has long been recognised that whensarcomata disseminate, the situations of secondary nodules indicatethat the distribution has been effected by means of veins. Thevenules issuing from a sarcoma will often be found plugged by smalloutrunners from the tumour, and occasionally, when a large sarcomaof the pelvic bones implicates the iliac veins, portions of the tumourwill travel alone: the lumen of the vein, and even extend into the. Fig:. 117.—Section of Lung, with Noauies of Sarcomasecondary to spindle-celled Tumour of the Testis.(Museum, Royal College of Surgeons.) SARCOMATA. 473 inferior vena cava (Fig. 118). This is not uncommon in connectionwith sarcoma of the kidney. Sometimes large pieces detached fromthese intravenous processes produce embolism of the pulmonaryartery, and have been so large as to obstruct the right auriculo-ventricular orifice. Secondary changes.—Sarcomata are very prone to degenerativechanges; for instance, haemorrhage is very apt to take place in those
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