. The diagnosis of diseases of women . with a chocolate-colored fluid. Sebaceous cysts are found in the labia, the base of the prepuce,and at the base of the hymen. They appear in the form of small,yellowish, semitransparent elevations filled with sebaceous , soft-walled cysts lying at the free margin of the hymen maybe regarded as lymph cysts. Dermoid cyst of the vulva is of rare occurrence. Vulvar cysts have little clinical significance. An accompanyingpruritus may disclose their presence. CANCER OF THE VULVA. The vulva is strangely exempt from infection and malignantdegenerati
. The diagnosis of diseases of women . with a chocolate-colored fluid. Sebaceous cysts are found in the labia, the base of the prepuce,and at the base of the hymen. They appear in the form of small,yellowish, semitransparent elevations filled with sebaceous , soft-walled cysts lying at the free margin of the hymen maybe regarded as lymph cysts. Dermoid cyst of the vulva is of rare occurrence. Vulvar cysts have little clinical significance. An accompanyingpruritus may disclose their presence. CANCER OF THE VULVA. The vulva is strangely exempt from infection and malignantdegeneration. In 1147 cancers of the female genitalia Schwarzfound 30 to be primary in the vulva. Wenkel tabulated the reportof 54 cases, in which he found 6 before the age of forty, 16 between DIAGI^OSIS OF DISEASES OF THE VULVA 259 forty and fifty, 20 between fifty and sixty, and 20 over sixty yearsof age. The site of predilection is the outer skin surface of the labiamajora; less frequent points of invasion are the frsenum, clitoris, Fig. 96. Carcinoma of the vulva. A cauliflower growth two inches in diameter is located in the rightlabium majora. The tumor was friable and bled freely to the touch. Bartholinean glands, anterior and posterior commissure, andurethral opening. The labia minora are seldom a primary site.(See Plate XXXVI.) The lesion is characterized by superficial infiltration, by ulcera-tion, and by early involvement of the inguinal glands. The growth 260 SPECIAL DIAGNOSIS may be diffuse or circumscribed. The circumscribed growthsrarely fail to rise above the level of the skin surface. They arecommonly round or oval, the surface smooth, nodular, or may grow to the size of a mans fist. At first firm in con-sistency, sooner or later they disintegrate and form ulcers more orless superficial. The diffuse form may not be evident to the nakedeye, and is recognized by its rigid, firm feel. Superficial ulcerationis usually not long in appearing. There is nothing un
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