CTIONDROMA.-OSTEOMA.
What hare been described by Velpeau and others as cartilaginous and bony tumors of the mamma are nothing else than true chondroma and osteoma, but.there.are „chalky formations in the walls of all cysts, and perhaps also chalky epithelial pearls, sand-like in small cysts. The only case, which seems with little doubt to be a partly bony chondroma, is the following described by Cooper: Maria F., thirty-two years old, had a tumor of the breast (right or left) for fourteen years; the tumor was very painful, and the skin covering it felt very warm compared with that of the surrounding parts, and required the constant use of evaporating lotions to moderate the warmth. The tumor was extraordinarily hard, painful to a high degree before menstruation, after which the pain moderated considerably. Various local remedies were used, such as cataplasms and irritating plasters, but they caused neither absorption nor suppuration, and as all discutient remedies had been used without result, the patient strenuously desired extirpation of the tumor.
As the axillary glands were free from diseased changes, and as the general condition of the patient, even after so long a duration of the disease, seemed good, Cooper recommended the operation.
On examining the tumor after removal, the greater part of it had the appearance of the cartilage which supplies the place of bone in young persons; the remainder was bony.
The illustration (at least in my copy of Cooper's work) is unfortunately quite imperfect. Neither the typical light blue color nor the distinct division of the cartilage by connective-tissue septa seen in sections of chondromata, is recognizable; that which should be bone, seems to be fat. Nevertheless it seems to be certain from the short anatomical description, as well as from the previous description of cartilage and bone develop ment in the embryo, that this was really a true chondroma. The ex tremely slow growth of the tumor, which was about as large as a duck's egg, is strongly in favor of chondroma, as also, in a slighter degree, the painfulness and at times almost inflammatory appearances of the tumor during its course. Perhaps the case will never be cleared up. Birkett searched in vain in the London museums for the preparation. Virchow cites cases from N6laton, Cruveilhier, Warren and E. Wagner, in which
it is probable that the tumors contained some cartilaginous tissue.
Thus far I have never seen in tumors sif the breast in men anything that had any resemblance to cartilage. However, I once found in a large myxo-sarcoma of the mamma a considerable mass of small, hard nodules as large as flax-seed, which consisted of true bone substance, which had developed from the connective tissue.
Cartilaginous tissue in various forms is not infrequently found in mam mary tumors of bitches. These, on the one hand, may pass over to myxomatous tissue, or may go on to true bone formation, with develop ment of medullary spaces.
I have already spoken of a layer of hyaline firm connective tissue, rich in nuclei, which surrounds the acini and smaller excretory ducts, and in virgin breasts, especially, is usually largely developed. This connective substance, which at the same time forms the floor upon which the epi thelia of the acini are fixed, and which first disappears where the firm walls of the excretory ducts begin, is the point of origin of all fibromata and sarcomata in the mammary gland. It follows from this that the gland-spaces may be easily influenced in their form and situation by the development of such tumors, and indeed under certain conditions must be so influenced. We will next consider the fibromatous tissue, which is here quite frequently formed, and is, as a rule, of a very pale yellowish red and of a firm homogeneous texture. It is not formed in regular bundles, loosely attached to one another, as is the subcutaneous cellular tissue, but is rigid and very hard to tear apart. In hardened sections, under the microscope, we see certain turnings of the fibre, shown only by the oval nuclei of the connective tissue cells, which are not very rich in protoplasm. These cells are abundantly strewn through the tissue, generally evenly distributed, and seldom heaped in groups; in some places, these heaps of partly round and partly spindle simple-shaped cells may be so large that we may well speak of a " fibro-sarcoma." It is a peculiarity of these tumors that their tissue is always the same, whether the nodules have existed one or ten years. They are not richly supplied with blood-vessels.