Klob' reports a case of this description, but so imperfectly that, to say the least, it can scarcely be regarded as conclusive. FOrster's diagnosis in the case of Glaser' is just as uncertain. At any rate, so great an author ity as Virchow' believes that in this instance a mistake may have been committed as between sarcoma and something else. Virchow himself (I. c. 172) reports some examples of myomata affected by cancerous disease. But Simpson,' the very man who is always quoted as the authority for this occurrence, emphatically states that he has never observed the car cinomatous degeneration of a fibroma. On the other hand, he has on sev eral occasions met the two affections side by side in the uterus, and in these cases he is inclined to attribute the development of the carcinoma to the continual local irritation excited by the presence of the other tumor. Kiwisch's cases are equally indefinite in this respect. Benporath and Liebmann' describe a fibroma affected with cancerous infiltration, oc curring in a case of primary cancer of the vagina, the cancerous infiltration also involving that portion of the uterine wall immediately surrounding the fibroid. Heger states briefly that he has enucleated a submucous myoma, " on that side of which, lying next the mucous membrane, a car cinoma had developed, after perforation of the capsule." In view of the
uncertainty surrounding this subject, and the admitted rarity of cancerous degeneration of fibroids, the statements of Rodering (1 c.) appear very remarkable. This author mentions 24 instances of such degeneration occurring in 570 cases of fibroid. But it does not appear from his de scriptions whether these cases were supposed to be examples of transform ation of fibroid tumors into cancer, or whether there was a mere associ tion of distinct morbid processes. There is probably no unimpeachable case on record of cancerous degeneration affecting a fibroid. But it should be mentioned here that adenoma may lead to such a transformation, and further that the mucous membrane in cases of fibromyoma may as sume the character of a diffuse adenoma.
As previously stated, the association of epithelioma of the cervix with fibromyoma of the uterus is not uncommon. In these cases the combined affection runs a course parallel to that of cancer pure and simple, the ditional presence of a myoma being of very little account. In another chapter, when we reach the subject of sarcoma, we will investigate the question, whether fibromata may become transformed into sarcomata, or, rather, to speak more exactly, whether the former may undergo sarco matous degeneration.