Obstructions front fibrous tuntours attached to the pelvic ligaments. These are of rare occurrence, and have been found chiefly con nected with the sacro-sciatic ligaments.
The most remarkable examples are those re lated by Dr. Drew in the Edin. Med. and Surg. Journal for 1805 (vol. i. p. 20 ). The first of these tumours was taken from the body of a woman, who had died in consequence of its pressure upon the pelvic viscera. It was 16 inches in circumference, of a hard, gristly tex ture, with no appearance of vascularity, and was attached by a strong root, of the same texture, to the left sacro-sciatic ligaments, and interposed between the bones and viscera, but with no other attachment to the sur rounding parts. The second tumour was ex cised by Dr. Drew, by a formidable operation, from the pelvis of a woman in labour, who was afterwards safely delivered and recovered perfectly well and very speedily. The tumour was 14 inches in circumference, and weighed 2 lbs. 8 ounces. It grew from the right side, and filled the whole cavity of the pelvis so com pletely as to admit of one finger only being passed between it and the pubis, considerably interfering with the neck of the bladder and urethra. It was separated easily from the circumjacent tissues.
A somewhat similar case is related by Dr. Burns ; but, in this instance, the attachments of the tumour were much more extensive ; reaching from the pubic symphysis to the sacrum, and adhering intimately to the pelvic brim, being attached also to the obturator internus muscle, urethra, vagina and rectum, and apparently developed in the recto-vesical fascia. It was hard, somewhat irregular, and
scarcely moveable. The patient being in labour, Dr. Burns, by a bold operation, in which but little blood was lost, removed the tumour, which required to be almost dis sected out. The woman was soon after safely delivered of a still-born child, and, after some peritoneal inflammation, recovered.
Fibrous tumours attached to the pelvic pa rietes are distinguished frorn the fcetal head and tumours or the soft parts, by the immo bility of their attachments ; from exostoses, by their want of bony hardness ; and from os teo-sarcomatous tumours, by their uniformity of structure to the sense of touch.
Carcinomatous growths commonly affect the bones of the pelvis, by advancing from the contained viscera, the uterus, rectum or ova ries. Dr. A. Farre mentioned to me a case in which the innominate bones were so inuch infiltrated by cancerous matter, from a tumour commencing in the uterus, that they could, with great ease, be cut with the knife, pre senting a condition very similar to the bones affected with mollities ossiwn.