The pathology and surgical treatment of tumors . tood. The same has been observed after amputation ofthe entire tongue for carcinoma. The function of deglutition is pre-served almost to perfection. Parotid.—Carcinoma of the parotid gland does not occur in personsless than forty years of age. Carcinoma of the salivary glands isnotoriously malignant. The acinous variety begins as a proliferation ofthe columnar epithelia of an isolated embryonic lobule of the gland(Fig. 183). The stroma is usually scanty in this varietj^ The tumorgrows rapidly and gives rise to early lymphatic infection. Weberdes
The pathology and surgical treatment of tumors . tood. The same has been observed after amputation ofthe entire tongue for carcinoma. The function of deglutition is pre-served almost to perfection. Parotid.—Carcinoma of the parotid gland does not occur in personsless than forty years of age. Carcinoma of the salivary glands isnotoriously malignant. The acinous variety begins as a proliferation ofthe columnar epithelia of an isolated embryonic lobule of the gland(Fig. 183). The stroma is usually scanty in this varietj^ The tumorgrows rapidly and gives rise to early lymphatic infection. Weberdescribed a form of carcinoma of the parotid that closely resembleshard carcinoma of the breast. The tubular variety begins in the distalbranches of the salivary duct, in the form of epithelial pearls of colum-nar epithelial cells which arrange themselves in the form of tubules,which multiply and grow into the substance of the gland. A rapid-growing tumor of the parotid gland in a person fifty or more years 296 PATHOLOGY AND TREATMENT OF of age is, with very few exceptions indeed, a carcinoma. The capsuleof the gland is perforated at an early stage, when the tumor involves the overlying skin and the neigh-boring organs. The externalear, the malar bone, and theascending ramus of the inferiormaxilla are frequently impH-cated. In two cases that havecome under the writers obser-vation paralysis of the facialnerve existed at the time theoperation was performed. Re-gional infection extends to thedeep lymphatics of the neck. Extirpation of the ParotidGland.—Extirpation of the par-otid gland was first performed inAmerica in 1804 by the fatherof J. Collins Warren. Brainardof Chicago performed the opera-tion a number of times, andKonig advises in the aged aview of preventing facial paral-ysis if the tumor is not large. The writer is of the opinion thatpartial removal of the parotid gland for carcinoma is an unjustifiableand unsurgical procedure, as recurrence is sure to take pl
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Keywords: ., bookcentury1800, bookdecade1890, booksubjectneoplas, bookyear1895
