Quiet polypoid sarcoma of the nose / by Frank Cole Madden.

  • Madden, Frank Cole, 1873-1929.
Date:
1910
Catalogue details

Licence: In copyright

Credit: Quiet polypoid sarcoma of the nose / by Frank Cole Madden. 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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    4 is one of a boy of 14, who came to Kasr-el-Ainy Hospital with signs of nasal obstruction and deafness. Each side of the nose was found to be completely blocked by a mass of red fleshy growth, which gave one the impression of a solid mass rather than a collection of pedunculated polypi. It was not possible to ascertain the seat of origin of the mass nor, unfortunatel)'-, have I ever been lucky enough to determine this in any of my cases. The mass in the right nostril can be seen as a black shadow in the photograph. The mucous membrane in front of the mass was dry and atrophic and secreted some thin muco-pus, which sometimes formed a definite crust at the anterior nares. The nose has begun to expand arid the skin over its lower half is greasy, with much enlarged sebaceous ducts, and of a peculiar pig-skin (cuir d’orange) appearance. It is elastic and harder than natural; but with no sensation comparable to that of scleroderma or rhinoscleroma. The breadth of the nose is already con- siderably increased, and the very suggestive “ donkey's saddle ” (Ar. Sarg-el-homar) shape is already becoming apparent. The anterior nares are dilated, and the boy is a typical mouth-breather. The general aspect is that of a pro- nounced snub nose, but without, at this stage, any tilting of the tip. There is no thickening of the columella yet, or any evidence of extension beyond the actual nasal passages. The boy gave a two years' history, but this is probably too short, as, in our experience, the disease is so very slow in developing. Photograph 2 gives a rather different view of the same case, which represents the earliest stage in the disease we have met with. Photographs 3, 4, and 5 (the last two being taken seven years later than the first) are of an Egyptian woman, aged thirty-five, who came for treatment originally for a small hard, mucous-like polypus, which was projecting from the anterior nares. The nose gradually expanded, became flattened, and presented a peculiar saddle-shaped appearance, the skin at the same time becoming hard and thick, very like pig-skin, with much hypertrophied sebaceous glands, and a wide separation between the individual hair follicles. The openings of the nostrils soon became completely occluded and a thick hard collar of fleshy substance protruded. Ihe upper lip was never