A case of dermoid tumor of both ovaries complicated by a deposit of bone upon each side of the true pelvis, having no connection with the tumors / by Charles P. Noble and Joseph P. Tunis.

  • Noble, Charles P. (Charles Percy), 1863-1935.
Date:
1895
Catalogue details

Licence: Public Domain Mark

Credit: A case of dermoid tumor of both ovaries complicated by a deposit of bone upon each side of the true pelvis, having no connection with the tumors / by Charles P. Noble and Joseph P. Tunis. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    Extracted from A CASE OF DERMOrD TUMOR OF BOTH OVARIES COMPLI- CATED BY A DEPOSIT OF BONE UPON EACH SIDE OF THE TRUE PELVIS, HAVING NO CONNECTION WITH THE TUMORS.1 By Charles P. Noble, M.D., AND Joseph P. Tunis, M.D. Although the presence of calcareous matter in and around the ovary has been frequently demonstrated by abdominal surgeons of large expe- rience, a careful examination of the masses removed has almost inva- riably proved that they were examples of simple calcification, and not of true ossification as had been supposed. Macroscopically, it is im- possible to make a positive diagnosis. These calcareous masses resemble very closely irregular lumps of bone. They may be irregularly nodular in outline, of such a firm structure as to require the use of a saw before they can be divided, and yet on cross-section they present no regularity of structure, but are, as a rule, made up of a homogeneous deposit of lime salts, more or less firmly held together by a fibrous stroma. In the great majority of cases when these masses have been examined under the microscope no evidence of true bone has been found. When, there- fore, unmistakable evidence of commencing ossification was demon- strated under the microscope in the specimen removed from the patient about to be described, the case was deemed of sufficient interest to report in detail. Some features of this case are unique. The history is as follows: Mrs. T., aged twenty-four years, has always been sterile. Her men- struation began at the age of fourteen. It was never regular, and lasted from one-half to two days. She has always had severe pain before and after the menstrual periods. Her general health has been fairly good, and when she came under observation she was well nourished. She com- plained especially of abdominal and pelvic pain of very marked character, which was becoming rapidly worse, so as to prevent her from performing her accustomed duties. She complained also of leucorrhoea; and of the presence of a tumor in the abdomen, which she first noticed eighteen months ago. Upon examination, the outlines of a cystic tumor could be readily felt filling the pelvis and extending as high as the umbilicus. From the history and the physical condition present a diagnosis of ovarian tumor was made, the inference being that it was of a dermoid 1 Read before the College of Physicians, Philadelphia, October 2,1895.