. Gynecology : . he tumor is benign andshows a growth of glandular tubes lying close together with slight connective-tissue glands are lined with regular cylindric epithelium. The structure shows the histologiccharacteristics of the sweat-glands; hence the name (Stern). CARCINOMA OF VULVA Cancer of the vulva is comparatively uncommon, and does not usually appearuntil after middle life. It takes its origin chiefly from the urethral orifice, from theclitoris, and from the sulcus between the greater and lesser lips, rarely fromBartholins glands. In advanced cases the origin cannot usua
. Gynecology : . he tumor is benign andshows a growth of glandular tubes lying close together with slight connective-tissue glands are lined with regular cylindric epithelium. The structure shows the histologiccharacteristics of the sweat-glands; hence the name (Stern). CARCINOMA OF VULVA Cancer of the vulva is comparatively uncommon, and does not usually appearuntil after middle life. It takes its origin chiefly from the urethral orifice, from theclitoris, and from the sulcus between the greater and lesser lips, rarely fromBartholins glands. In advanced cases the origin cannot usually be distinguished. 288 GYNECOLOGY The great majority of cancers of the vulva are of the squamous epithelialtype, but growths from Bartholins glands are adenocarcinomatous, while arare form of melanotic carcinoma has been described. It is possible for cancerof the uterus to become secondarily implanted on the vulva, in which case thegrowth has the histologic structure of the primary tumor. As a rule, the growth. *> mr j**- s. Fig. 68—Early Cancer of the Vulva, with Infiltration of the Tissues at the PosteriorCommissure and Beginning Ulceration. appears on one side, and is at first irregular and nodular, without ulceration, andis surrounded by a more or less kraurotic tissue, from which it seems to spring. On account of the rich lymphatic circulation of the vulva, cancer in thislocation is extremely malignant, and metastasizes early to the inguinal lymph-glands, and thence to the glands of the iliac system. The disease in the early stages is not painful, and does not at this time oftencome to the notice of the physician, symptoms ensuing when the tumor becomes NEW GROWTHS 289 ulcerated or when the inguinal glands become infected. Locally the diseasegives rise to itching and burning and a bloody foul secretion bathing the externalparts. The involvement of the inguinal glands may be very extensive andexceed in severity the processes of the primary growth. The pa
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