A case of primary cancerous tumour of the brain : with remarks / by G. Mackenzie Bacon.

  • Bacon, G. Mackenzie.
Date:
[1864]
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Licence: Public Domain Mark

Credit: A case of primary cancerous tumour of the brain : with remarks / by G. Mackenzie Bacon. 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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    rost-mortem,—Body somewhat emaciated; viscera in chast and abdomen healtliy; membranes of brain healthy. On slicing the right liemisphere, the white centre had' a bright pinkish hue, and seemed softened, but on continuing the section deeper the cerebral substance was denser, and the right ventricle when exposed was found almost obliterated by a hard mass, of gelatiniform appearance, witli s])ots of effused blood, like old apoplectic clots. This mass extended upwards through tlie roof of the ventricle, causing an induration of some portion of the hemisphere, and was of the size of a small orange. A similar growth, of less size, was seen commencingin the left hemisphere, but external to the ventricle. Microscopical Examination.—Dr. Eade, of Norwich, well knowi for his skill and ex- perience in the use of the microscope, kindly examined the tumour, and furnished the following particulars of the microscopical appearances:—“Tlie tumour presented an ir- regular nodulated appearance. Sections of various portions of it showed a more or less brain-like appearance, and a var5'ing degree of consistency. “ Under the microscope the following elements were found:— “ 1. Large irregular cells, mostly with one large eccentric nucleus. “ 2. More or less rounded or oval cells, with one nucleus, which was variously centric or eccentric. “ 3. Cells in every stage of elongation and fibrillation, from the mere oat-shaped or pyriform cell to the long delicate fibrillte or fibre cells. These elongated cells were all granular on the surface, and many of them had a long, bulging, central nucleus, some ap- pearing more or less perfectly joined at their extremities in a rudimentary attempt to form fibres. These elements varied greatly in relative amount in the different portions of the tumour; the firmer portions containmg the largest proportion of fibres, and the soft and diffluent portions being chiefly composed of the roimded or oval cells.” The writer regrets that no examination was made of the spinal cord, but illness pre- vented his completing the autopsy. The results of cerebral pathology are so unsatisfactory, as ex- planatory of morbid mental phenomena, that one looks with eagerness to cases where an obvions lesion exists, in the hope of gaining some fresh light, but the jiresent instance hardly favours such hojies, for the man’s mental condition seemed hardly altered till the loss of physical power extinguished the vivacity of his emotions. There is also a ciu’ious want of coincidence between the extent of the disease and the jiaralysis. In reviewing this case, one is chiefly struck by the rarity of a large tumour in the brain, still more so of a malignant one ; and also by the comparatively slight symptoms produced. Dr. Sutherland states, in his ‘ Croonian Lectiu’es,’ “It is rare to find tumours in the substance of the brain, in oases of in- sanity ; in 200 cases, tumours were found in only fourwhile the French statistics ascribe twenty-two out of 8289 deaths to cancer of the brain. The case is, however, singular, as an in- stance of primary cerebral cancer, unassociated Avith other disease, for in the ordinary way cancerous deposits within the cranium are secondary to disease elsewhere. The oul}’’ local sign, too, supposed to indicate the existence of tumour in the brain,^ viz., headache, was entirely absent throughout. In treating ot this subject. Dr. Walshe remarks : “ The presence of a tumour in the brain must, we should expect, be productive of some form of paralysis. The fact is, however, otherwise, for Oalmeil found three eighths of those Avith organic disease of the eu-