CANCER RESEARCH 25 



deaths in the female sex are due to cancer (Hoffman). From the 

 thirty-fifth year on the death rate from cancer increases rapidly. There 

 seems to be an optimal age for the appearance of certain cancers which 

 differs somewhat in various kinds of cancer. Whether the death rate 

 from cancer as a whole increases with advancing age or whether there 

 occurs a maximal death rate at a certain age after which there is again 

 a decrease observed does not appear to be certain. 



While the typical cancers which we have considered so far occur in 

 the large majority of cases in older people, some cancers of the same 

 type may appear in young people; thus carcinoma of the stomach, 

 tongue, esophagus, appeared in very rare cases in children. But there 

 are special kinds of cancer which appear typically in younger persons. 

 This applies for instance to the "carcinoid" tumor of the appendix 

 and to similar often multiple carcinomata of the small intestines, which 

 are found in relatively young adults (Bunting). These tumors are 

 much more benign than the typical carcinomata — they grow very slowly 

 and make ordinarily no metastases. But certain tumors are quite 

 typical for young children. While in adults carcinomata are consider- 

 ably more frequent than sarcomata, in children sarcomata are much 

 more numerous than carcinomata. The most frequent seats of cancer in 

 children are neither the gastro-intestinal tract nor the female generative 

 organs, but kidney and adrenal, next the eye, brain, skin, cranium and 

 liver. And while the few carcinomata of the stomach and intestines in 

 childhood are observed in 12-14 year old children, the tumors of the 

 kidney appear often in infants. 



Besides the sarcomata we find in young children frequently so-called 

 mixed tumors, consisting of several kinds of tissue; in the kidney 

 tumors for instance we may find side by side proliferating epithelial 

 gland tissue, round cells resembling sarcoma, muscle and even bone- 

 like tissue. In other organs also we find not rarely such mixed tumors 

 to prevail among the cancers in children. Cancer of the female gen- 

 erative organs occurs in children not mainly in the uterus, as is the case 

 in adults, but in the ovaries and in the vagina. In the eye and brain 

 we find besides sarcomata which originate from connective tissue cells 

 certain special kinds of structures, the so-called glia cells — which are 

 related to nerve cells — to give origin to malignant tumors. Even in the 

 abdominal organs there may appear in young persons tumor-like pro- 

 liferations of cells derived from the sympathetic nervous system (Neu- 

 roblastoma of J. H. Wright). 



There is still another class of tumors which occur especially in chil- 

 dren and in young adults, but may occasionally be observed even in 

 older people and which are of great interest, the so-called teratomata or 

 embryomata. They have certain seats of predilection, as for instance 

 in the pelvis in front of the sacral bone, or in the anterior mediastinum, 



