Gynaecology for students and practitioners . Fig. 277. Adbno-carcinoma of Cervix, tubular form. Multipara, aged 37. to spread into the deep tissues. Such a growth may reach the sizeof a fist and appear at the vulva, whilst its attachment to the portiomay be by a relatively thin base. The surface may be furrowed andlobulated, and is often deeply fissured {see Fig. 278). The largest growthsare extensively degenerated and covered with a greyish-green necroticlayer. Generally such large growths are not formed, because the newtissue rapidly necroses. This kind of growth has a strong tendency tospre
Gynaecology for students and practitioners . Fig. 277. Adbno-carcinoma of Cervix, tubular form. Multipara, aged 37. to spread into the deep tissues. Such a growth may reach the sizeof a fist and appear at the vulva, whilst its attachment to the portiomay be by a relatively thin base. The surface may be furrowed andlobulated, and is often deeply fissured {see Fig. 278). The largest growthsare extensively degenerated and covered with a greyish-green necroticlayer. Generally such large growths are not formed, because the newtissue rapidly necroses. This kind of growth has a strong tendency tospread along the vagina, by direct continuity or by contact-implanta-tion. In such cases the cancer-cells may penetrate the vaginal mucousmembrane and involve the paravaginal tissues ; it may then breakthrough into the vaginal wall and appear at another spot. Another equally if not more frequent form of the proliferative typeis the medullary cancer, which arises from the deep layers of the CANCER OF THE CERVIX 527. .< is, 11 o ? ^ w H ^ o izi O IH H « O Ph «! g O >> g S >! o J o >^ -2 Ph 03 P^ >. O -q fa eS O o <J -tJ o °o ;z; 5 o 5 JH P5 •t^ << J S H J O -s M ® o ^ S >. TS c? CD 02 > faO O a QJ K > H O P3 H fa HH •J o » CM 528 GYNECOLOGY epithelium of the portio vaginalis or from the epithelium of the cer-vical endometrium. Even when it arises from the deep layers of thesquamous epithelium of the portio, it spreads, from the first, into thedepths of the cervix, and is therefore intracervical in position, hence theterm medullary, which is used in reference to its deep situation, and inno way refers to the structure, or consistence of the growth. Theseproliferative growths at first form spherical, nodal masses of cancer{see Figs. 269 and 270, p. 518) in the tissues of the portio and supra-vaginal cervix. The cervix as a whole is much enlarged circumferen-tially and rendered irregular in shape
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Keywords: ., bookcentury1900, bookdecade1910, booksubjectgynecology, bookyear1
