. The Principles and practice of gynecology : for students and practitioners. he tendency of the ulcers to cicatrize,by the slight liability of extension to the inguinal glands, and by theslow progre>s of the disease. Epithelioma destroys life in about twoyears after the beginning of ulceration. Syphilis may be differentiatedby the history of infection, by the presence of secondary and tertiarylesions elsewhere, and by the effect of specific treatment. Cylindrical Cell Carcinoma—Adenocarcinoma.—The swellingbegins more deeply in the cellular tissue, and is characterized by irreg- 340 TUMORS,
. The Principles and practice of gynecology : for students and practitioners. he tendency of the ulcers to cicatrize,by the slight liability of extension to the inguinal glands, and by theslow progre>s of the disease. Epithelioma destroys life in about twoyears after the beginning of ulceration. Syphilis may be differentiatedby the history of infection, by the presence of secondary and tertiarylesions elsewhere, and by the effect of specific treatment. Cylindrical Cell Carcinoma—Adenocarcinoma.—The swellingbegins more deeply in the cellular tissue, and is characterized by irreg- 340 TUMORS, TUBAL PREGNANCY, MALFORMATIONS. ular-shaped cylindrical cells imbedded in the meshes of connective-tissne fibres and by more rapid progress than that of epithelioma. Thetumor more rapidly breaks down, the hemorrhage is frequent and pro-fuse, the ichorous discharge is abundant, the inguinal glands are enlargedearly, and systemic eiFects appear earlier and are more marked. Thedisease terminates in sepsis and marasmus. Death occurs earlier thanin epithelioma. Figure Carcinoma of ihe vulva. The Treatment is radical excision if possible before glandular in-volvement. SARCOMA OF THE VULVA. Sarcoma is of mesoblastic origin and is so rare in the vulva as topreclude accurate description. The possible varieties are : first, roundcell; second, spindle cell; third, myxosarcoma; fourth, melanosar-coma. They preferably develop in the labia majora, but have beenfound in the nymphse. The growth, according to the variety, may beslow, resembling that of lipoma;^ or ulceration may be early, rapid,and destructive.^ The usual characteristics of sarcoma of the vulva « Henkel. 2 Hildebrandt. TUMOnS OF THE VULVA AND VAGINA. 341 arc rapid growth, late ulceration, variable lieniorrhafjcs, and late in-volvement of the inijninal inlands. The systemic breakdown, thontihmore raj)id and marked, Icsemhles that of ear(;in(»nia. i\ll recordedeases have terminated fatally. Death usually results from
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