Gynecology . though cases of spontaneous cure even at this stage have beenreported. Metastases frequently occur in the vagina, and sometimes the first evidenceof the disease is seen here, the chief symptom being bleeding. On account of thecorrosive action of the tumor and the friability of its tissue, metastatic emboli NEW GROWTHS 319 slip very readily into the blood-stream and are carried to distant parts of thebody. The embolic masses when lodged grow and corrode the neighboringblood-vessels, causing local hemorrhages. Sometimes symptoms from themetastatic growths give the first warning of t
Gynecology . though cases of spontaneous cure even at this stage have beenreported. Metastases frequently occur in the vagina, and sometimes the first evidenceof the disease is seen here, the chief symptom being bleeding. On account of thecorrosive action of the tumor and the friability of its tissue, metastatic emboli NEW GROWTHS 319 slip very readily into the blood-stream and are carried to distant parts of thebody. The embolic masses when lodged grow and corrode the neighboringblood-vessels, causing local hemorrhages. Sometimes symptoms from themetastatic growths give the first warning of the disease without uterine mani-festations. Metastases to the lungs are especially common, and cause pulmonaryhemorrhages, or they may be localized in the brain, liver, or kidneys, etc. In making a diagnosis of chorio-epithelioma, and coming to a decision as tothe treatment, the surgeon often finds himself in a serious predicament. Thesituation which presents itself in a suspected case is somewhat as follows:. Fig. 119.— power. This tissue consists of Langhans cells. The nuclei and cell protoplasm do notstain as deeply as they do in syncytium, the nuclei are not as large, and the cell boundaries can beseen. No cell walls are found in syncytium, it being held together by fine protoplasmic threads. A patient, some time after delivery of a hydatidiform mole or after an abortion,begins to bleed profusely. A curetingis done, and a considerable amount oftissue is removed from the uterine canal, which, on microscopic examination,shows numerous fetal elements. Many Langhans cells are seen in groups,and in different places may be seen great syncytial masses with large, variouslyformed protoplasm. Such a picture may correspond either to a placental restor to a benign form of chorio-epithelioma, or to an early stage of a malignantchorio-epithelioma. If radical operation is done there is a chance that the 320 GYNECOLOGY patient will be subjected to needless danger,
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