ANGEIECTOMA.
Masses of variable size composed of dilated and elongated vessels may be described under the name of angeiectoma (avyttov eivrEtvs)). They are rare productions, and seem essen tially produced by dilated hypertrophy of the small vessels, venous or arterial.
A tumour of this kind has been figured by Dr. Carswell, (Fascic. Melanoma, pl. ii. fig. 2). It was sunk into the substance of the brain, but evidently in connection with the pia mater. " The bloodvessels of the pia-mater passed into it, and constituted by far the greater part of the tumour. They became tortuous in its substance ; some of them, being nearly a line in diameter, were reflected back wards at their extremities in the form of irre gular intertwined bundles, towards which two or three small arteries, coming from the pia mater, were seen to distribute themselves." Lobstein (Anat. Path. t. p. 461) describes a similar mass formed of a venous plexus. In both these cases the veins contained, and were bathed in, melanic liquid. Dr. Warren (On Tumours) figures and describes a case of con genital tumour composed of greatly dilated and knotty veins seated in the neck.
There is a species of epulis which appears to be composed of dilated and hypertrophous arteries. Cruveilhier (Anat. Pathol. livrais. 33.) describes certain tumours on the surface of the skull, tulsatile, erectile, and the seat of blowing arterial murmur, which had eroded the bone ; there were similar forma tions in the external soft parts ; they were composed of dilated "arterial capillaries." A man was admitted some years ago into Univ. College Hospital (Mus. Model 2851), under Mr. Liston, having a series of pale red, knotty tuberosities, extending from the left orbit to the occiput, pulsatile, erectile, and the seat of blowing murmur at a particular point. Death ensuing, Mr. Marshall examined the larger of the series, and found that it con sisted in the main of dilated and tortuous arteries, with intervening fibrous tissue and granular fat ; large straight veins existed, and one or two of these uniting at obtuse angles, passed between (but did not communi cate with) the arterial branches at the site of the blowing murmur. No true erectile struc ture was to be seen.
Tumours of this kind (such are many nmvi, ncevi verrucosi, and aneurisms by anastomo sis), because physiologically erectile, have been presumed to be anatomically so, and con founded with Growths composed of true erec tile tissue.
Allied, at least in its functional characters, to angeiectoma, is the growth composed of true erectile (or cavernous) tissue. Soft, doughy, pseudo-fluctuating, pulsatile, erectile, the occasional seat of tactile fremitus and blowing murmur, occurring generally in a single, but sometimes in many spots, com monly cutaneous or sub-cutaneous, but liable to grow in deep-seated parts, congenital or accidental, rarely exceeding a Seville orange in size, and often very small, traceable in rare cases to the influence of pressure or other external injury ; sometimes of rapid, oftener of very slow- progress; the true erectile tu mour has a structure perfectly assimilable to that of cavernous tissue, and, like this, a structure not y et thoroughly unravelled. On section these growths (fig. 94) exhibit on a coarse scale the interlaced columnar appearance of erectile tissue : the trabeculm vary in thickness and density, and are pro vided with minute vessels ; the hollow spaces between these are shallow or deep, narrow or broad, quadrangular or triangular, and com municate with each other. Microscopically the trabecul2e are found to be composed of fasciculated, cellular or fibrous (in very rare instances of intermingled elasti4 fibrils, coated with tesselated epithelium, which conse quently also lines the hollow interspaces. When these trabeculw are in process of growth they contain fusiform cells.
Such Growths are never encysted, but they sometimes acquire a secondary capsule of condensed cellulo-fibrous membrane. It is said they are sometimes lobulated, a condition in which we have never seen them. They are rapidly regenerated if imperfectly removed. Particularly when connected with the skin, erectile structures may become the seat of cancerous formation.
Erectile Growths generally appear in super ficial parts, the skin and subjacent cellular membrane ; the mucous membrane of the anus (as a rare variety of pile) ; the gingival membrane (?); the tongue (Brown, in Lancet, 1833). Mr. Liston (Med. Chir. Trans. vol. xxvi.) describes an erectile tumour (Univ. Coll. Mus.) seated in the substance of the serni-tendinosus muscle; Andra] (An. Path. i. p. 463) speaks as if the structure were not uncommon in the intestines,—but we hav e never seen it here; Lobstein describes it in the liver (?); Rayer (Maladies des Reins, t. p. 612) in the kidney.