Gynaecology for students and practitioners . d, but often the portio as such has disappeared,and the walls of the ulcer are flush with the vaginal fornices {seeFig. 280). The walls of the conical crateriform ulcer thus formed,consist of sloughy, crumbling, hsemorrhagic masses of growth, whichon examination may come away by contact with the examiningfinger. With this form of cancer, infiltration of the parametriumis most rapid, metastases are most common, and often it establishesfistulous communications with the bladder and rectum. It may safelybe said that of all types of cervical cancer, the
Gynaecology for students and practitioners . d, but often the portio as such has disappeared,and the walls of the ulcer are flush with the vaginal fornices {seeFig. 280). The walls of the conical crateriform ulcer thus formed,consist of sloughy, crumbling, hsemorrhagic masses of growth, whichon examination may come away by contact with the examiningfinger. With this form of cancer, infiltration of the parametriumis most rapid, metastases are most common, and often it establishesfistulous communications with the bladder and rectum. It may safelybe said that of all types of cervical cancer, the endocervical (medul-lary) type is the most destructive. (2) The Ulcerative Type. Far less frequent than either of thepreceding, is the cancer which produces a flat sore with a shallow, hardedge. It probably starts in an erosion. There is relatively littletendency for this type of growth to penetrate deeply ; it spreadsvery gradually, and somewhat resembles the rodent ulcer of theexternal skin. It is found especially in elderly subjects, and. Fig. 279. Ekdocervical (Mediallary) Carcinoma of Cervix show-ing Early Ulceration. CANCER OF THE CERVIX 529 at its onset is difficult to diagnose from an erosion, or from simpleulceration. A still rarer form of cancer is met with also in old subjects in whichthe tendency to ulceration is very slight. It consists of a hardpuckered induration of one or other lip of the portio vaginalis. Itbleeds but slightly on contact and shows little tendency to disintegra-
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Keywords: ., bookcentury1900, bookdecade1910, booksubjectgynecology, bookyear1
