CARCINOMATA AND SARCOMATA.
Carcinoma usually occurs in the broad ligaments and the pelvic peri toneum in connection with similar disease of the general peritoneal sac. Occasionally an ovarian carcinoma may spread to the broad ligaments, or a cancer of the uterus may spread into the neighboring peritoneum and connective tissue. Carcinoma originating in the rectum or the bladder may attack the pelvic connective tissue, and so reach the uterus. Accord ing to Blob, E. Wagner's case is unique, in which a cancroid commenced in Douglas's pouch, and spread to the uterus.
The carcinomata are of practical importance on account of their grave prognosis, and because of the ease with which they may be mistaken for other tumors arising from the pelvic walls or some spot in the sub-perito neal tissue.
We have several times observed the affection together with cancerous disease of the retro-peritoneal glands of the posterior pelvic wall. In two cases the disease began insidiously, and without its dangerous character being in the least suspected. There occurred attacks of pain in the abdo
men, loins, and back, which afterwards became more violent and contin uous. During three months, in which the patient lost flesh rapidly, and could neither eat nor sleep, repeated examinations were made by several physicians, without finding any cause for the pain. It is interesting to note that in one of these cases, the disease was chiefly confined to the glands of the left side of the body; three months after the affection began, small tumors could be felt near the uterus and the left upper extremity; the side of the face, then the left lower extremity and the left side of the thorax and the pelvis became cedematous, and there remained a hard cedematous swelling of the left side of the body, exactly limited to the middle line. Death occurred in both cases about eight months after the beginning of the affection.
(Concerning new growths, myomata sarcomata and carcinomata, which have spread from the uterus to the parametrium, see Gusserow.)