Gynaecology for students and practitioners . esare formed in the centre of the cell-masses {see Fig. 172). Cell nests are seldom seen, and when present they are smalland ill-developed. Kodent ulcer of the vulva is only seen in elderly women and isexceedingly rare. If seen early it appears as a smooth flattenednodule in the skin of the labium majus, it causes no pain, and is notaccompanied by a zone of hypersemia. Later on, the thin epitheliumcovering the centre of the papulae ulcerates, after which, gro^^i;h inthe depths and surface-ulceration progress pari passu. The ulcer has a smooth surfac
Gynaecology for students and practitioners . esare formed in the centre of the cell-masses {see Fig. 172). Cell nests are seldom seen, and when present they are smalland ill-developed. Kodent ulcer of the vulva is only seen in elderly women and isexceedingly rare. If seen early it appears as a smooth flattenednodule in the skin of the labium majus, it causes no pain, and is notaccompanied by a zone of hypersemia. Later on, the thin epitheliumcovering the centre of the papulae ulcerates, after which, gro^^i;h inthe depths and surface-ulceration progress pari passu. The ulcer has a smooth surface which is slightly depressed, and 360 GYNECOLOGY limited by an irregular, hard rolled-over edge. The discharge is thinwatery pus. Lymphatic glands and viscera are never invaded, butby local infiltration the growth may spread to, and erode, the pubicbones. The progress of the growth is very slow indeed, and of allmalignant epithelial growths the rodent ulcer is the most treatment is free removal, bearing in mind the fact that the. Fig. 173. Epithelial Processes oe Rodent Ulcer of the Labium MajtjsUNDER A High Power. (The same growth is shown ha Fig. 172.) growth may extend for some distance underneath apparently healthysurface-epithelium. Melanoma. This is a pigmented form of malignant new growthwhich occurs specially in deeply pigmented situations such as thechoroid coat of the retina and certain areas of the skin ; but it hasalso been known to develop in the mucous membrane of the hardpalate (Treves), and of the gums, and on the lips. It is a rare diseasein any situation, and particularly so in the vulva, although in thissituation it has been shown to occur rather more frequently thannon-pigmented sarcoma. When occurring on the genitals it especiallyeffects old women, 70 per cent, of the recorded cases having occurredabove the age of fifty (Holland). Melanoma of the vulva may be primary or secondary. In primarymelanoma the labium majus alone, or the labium minus an
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Keywords: ., bookcentury1900, bookdecade1910, booksubjectgynecology, bookyear1
