592 



UTERUS AND ITS APPENDAGES. 



as has been clone by Rokitansky and Lebert*, But such an arrangement, whilst recognisin^ 



with the other forms of cystic disease of the an important feature, often, but not always, 



ovary, on account of the frequency with which observed in colloid cancers of the ovary, of 



this form of cancer is found associated with necessity dissociates these cases from other 



ovarian cysts, especially of the larger class, congeneric forms of disease. In this particu- 



Fig. 398. 



Colloid cancer of tlie ovary. (After Cruveilhier.) 



lar respect colloid cancer appears to stand 

 between the various cystic diseases already 

 described, and those forms of cancer which 

 are not colloid, in the position of one of those 

 " esculent groups " which have been some- 

 times employed in classifications of the animal 

 kingdom as connecting links, to bring into 

 juxtaposition objects which, though exhibit- 

 ing certain near affinities, could not be in- 

 cluded in one common group, without violence 

 to the principles upon which a natural ar- 

 rangement should be based. 



Not, however, to enter further upon the 

 disputed question of the nature of alveolar 

 cancer of the ovary, it will suffice to notice 

 those peculiarities which are generally to be 

 observed when the disease affects that org;in. 



Since colloid cancer of the ovary does not 

 generally destroy life until the disease has made 

 great progress, the specimens of ovaries so af- 

 fected which come under our notice are often of 

 large size, filling the pelvis and abdomen, and 

 equalling in bulk the masses of cyst formation 

 of a more innocent type. Such a mass, when 

 incised, may be found to include the entire 

 ovarian structure, which is converted into a 

 collection of cysts, or alveolar cavities, varying 

 greatly in size and in the thickness of their 

 walls. Such a variety is often seen in dif- 

 ferent portions of the same structure. The 

 surface of a section may present in some parts 



* Rokitansky, however, regards these cases as 

 decidedly cancerous; while Lebert asserts that they 

 have nothing in common with colloid cancer except 

 the gelatinous contents of the cells. 



the appearance of a fine sponge, the alveolar 

 spaces being condensed and somewhat flat- 

 tened, in consequence of the profusion with 

 which the alveoli have been developed. In 

 other portions of the same tumour, and oc- 

 casionally as it were in separate lobules of it, 

 the alveoli are more expanded, and take a 

 round or oval form, assuming the condition of 

 distinct cysts, some of which may considerably 

 exceed the rest in magnitude. These larger 

 cysts may occupy a seat within the mass, or 

 project from its surface ; and probably in this 

 way arise those still larger cystic formations 

 in which one or more large sacs occur, having 

 connected with them masses of alveolar struc- 

 ture such as those just described. 



The interstitial substance, which constitutes 

 also the boundary walls of the alveoli and fol- 

 licles, is composed of a white, shining, fibrous 

 tissue, upon the density of which chiefly de- 

 pends the general hardness or softness of the 

 mass. This intermediate substance is in some 

 instances so thick that the cysts appear like 

 excavations in a dense medium, but often the 

 cyst walls are so thin that the peripheral follicles 

 project in the form of thin-walled sacs from 

 the surface, and the whole mass is sometimes 

 so feebly supported as to assume the appear- 

 ance of a trembling jelly. The thin-walled 

 cysts are generally richly supplied with blood- 

 vessels. 



These cysts are filled with a viscid mucous- 

 like material, resembling half-liquid jelly, which 

 is sometimes colourless, but oftener of a gray- 

 ish amber, yellow-green, or reddish hue. Im- 



