. Tumours, innocent and malignant; their clinical characters and appropriate treatment. rs affect bones. In some examples ofperiosteal sarcomas the medulla is invaded by processesof the tumour making their way along the veins traversingthe Haversian canals. The converse of this is also true,for a central sarcoma will sometimes implicate the perios-teum by w^ay of the Haversian canals. It is well established that most examples of centralsarcomas occur near the joint ends of bones, and yet itis exceptional to find the joints invaded. When joint in-vasion happens, it occurs late in the course of
. Tumours, innocent and malignant; their clinical characters and appropriate treatment. rs affect bones. In some examples ofperiosteal sarcomas the medulla is invaded by processesof the tumour making their way along the veins traversingthe Haversian canals. The converse of this is also true,for a central sarcoma will sometimes implicate the perios-teum by w^ay of the Haversian canals. It is well established that most examples of centralsarcomas occur near the joint ends of bones, and yet itis exceptional to find the joints invaded. When joint in-vasion happens, it occurs late in the course of the disease,and then, in most cases, the tumour creeps in throughthe synovial membrane. This comparative immunity ofjoints is usually attributed to the articular cartilage acting 68 CONNECTIVE-TISSUE TUMOURS as neutral tissue; but it appears rather to be due to thefact that the cartilage, unlike the compact tissue of bone,is not traversed by a multitude of narrow venous chan-nels. Extraordinary examples of the invasion of veins bysarcomas occur in the abdomen. In cases of renal sar-. Inferior vena cava. Intravenous processof the sarcoma. Glands infected bysarcoma. J A sarcoma springing i^ from tlie ilium. Fig. 41.—Periosteal sarcoma of the ilium invading the inferior vena cava,{lliiseum, St. BarthoIo)neu-s Hospital.) comas, processes of tumour will find their way into therenal vein, and thus enter the inferior vena cava. Periostealsarcomas of the pelvic surface of the ilium are veryliable to infiltrate the iliac veins and extend into the venacava (Fig. 41). When processes from a sarcoma project intoa vein, the circulating blood is apt to detach large frag-ments, and these become dangerous emboli. The mere presence of a sarcomatous outrunner in a vein SARCOMAS i 69 does not necessarily imply dissemination of the sarcoma,for very large intravenous processes may exist, and thelungs be free from any gross lesion of a sarcomatousnature. On the other hand, a very small invasion may
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Keywords: ., bookcentury1900, bookdecade1910, booksubjectneoplasms, bookyear19
