. Gynecology : . carcinomata may start as malignanttumors, or they may represent a carcinomatous degeneration of a benign papil-lary cystadenoma. The appearance of a malignant papillary cyst so closelyresembles that of the benign cystomata that often they can hardly be differ-entiated macroscopically. The a cancerous cyst are apt to be opaqueor bloody, due to desquamation and breaking off of the papillary excrescences. NEW GROWTHS 399 Microscopically, the anatomic appearance resembles closely that of cancerof the body of the uterus. Serous cystadenomata are much more prone to under
. Gynecology : . carcinomata may start as malignanttumors, or they may represent a carcinomatous degeneration of a benign papil-lary cystadenoma. The appearance of a malignant papillary cyst so closelyresembles that of the benign cystomata that often they can hardly be differ-entiated macroscopically. The a cancerous cyst are apt to be opaqueor bloody, due to desquamation and breaking off of the papillary excrescences. NEW GROWTHS 399 Microscopically, the anatomic appearance resembles closely that of cancerof the body of the uterus. Serous cystadenomata are much more prone to undergo carcinomatous de-generation than is the pseudomucinous variety, especially if they show tendencyto papillary growth. According to Pfannenstiel, at least one-half of the papil-lary cysts of the ovary are malignant, and, as they cannot always be distin-guished from the benign form, all papillary cystadenomata of the ovaries shouldbe surgically treated as if they were malignant. Clinically, the cystic carcinomata. Fig. 149.—Serous Cystadenoma of the power of a papilla. The top of the papilla, at the right, is very edematous as compared withits base, at the left. The tips of the papilla? may become so edematous as to appear cystic. Theepithelial covering may consist of one to several layers of cells which, in the inverting type, where thepapilla lies in a cyst, may show cilia. Dilated lymph-spaces are seen in the tip near the center, and agland to the right. Above is a further branch of the papilla. are extremely malignant, and tend to recurrence even when they are apparentlyentirely removed by operation. (c) Metastatic Carcinoma of Ovary.—It should be remembered that manycancers of the ovary are secondary to cancers of other organs, such as the stom-ach, gall-bladder, intestines, breast, uterus, and tubes, and have the anatomiccharacteristics of the original tumor. It is a matter of debate as to how theovary becomes secondarily involved by malignant growths starti
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