A contribution to the pathology of orbital tumors : being a study of the secondary processes in the periosteum and bones of the orbit and vicinity / by Charles Stedman Bull.

  • Bull, Charles Stedman, 1844-1912.
Date:
[1881]
Catalogue details

Licence: Public Domain Mark

Credit: A contribution to the pathology of orbital tumors : being a study of the secondary processes in the periosteum and bones of the orbit and vicinity / by Charles Stedman Bull. Source: Wellcome Collection.

Provider: This material has been provided by UCL Library Services. The original may be consulted at UCL (University College London)

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    tion of the osseous tissue takes place, and the secondary or spongy state is reached. Whether this stage is identical with that in which the bone is infiltrated with giant cells, like those contained in the sarcoma of bones and the orbit, is a matter which will admit of discussion. Sarcoma is recognized as belonging to the group of connective- tissue tumors, but is distinguished from types of this group by the preponderance of its cellular constituents, both in size and in number. In the orbit the amount of connective tissue is considerable, though the meshes are very loose and most of them large, and we should naturally expect to find in sarcomata developed here a considerable amount of connective tissue; but this is not often the case. The intercellular substance here, though it may be fibrillar, is very apt to be granular and even homogeneous, while the cells enormously preponderate. The influence of locality upon the development of sarcomata is said to be clearly evident, the osteo-sarcomata appearing on the surface of bones, while the softer forms, rich in cells, arise in the medullary cavity. But in the orbit it would seem as if the tumors were very frequently of the medullary variety. A myxomatous element is very often present in sarcomatous tumors of the orbit, especially in the recurrent growths. As a rule, the more developed the cellular element of a sarcoma is, the more rapidly does it grow and the farther it extends, and this is especially true of the orbit. Here the neoplasm does not grow in one direction only, but in all directions along the small blood-vessels and lymphatics, though it may tend to grow more in one direction than in others. Another fact to be remembered, as of especial importance in the orbit, is that, when these tumors recur after extirpation, the recurring growths are always richer in cells than the original tumor ; they consequently grow much more rapidly, and are more apt to be myxo-sarcomatous than purely sarcomatous. The size and rapidity of growth of a tumor in the orbit are usually indicative of its nature, and its growth here seems generally to be entirely beyond the laws which govern ordinary development in the body. Of course, in all cases of malignant orbital tumors, the great danger is the extension of the growth into the cavity of the skull. This may take place through the preexisting normal anatomical canals or openings, like the optic foramen or the sphe- noidal fissure, or by destruction of the roof of the orbit by caries, beginning, according to Perls, as an osteitis, and ending in menin- gitis and encephalitis. The more frequent form of extension is, however, probably by dissemination of the cellular elements of the