OVARIAN PREGNANCY. 261 



and both membranes are very degenerate and destroyed amost completely in 

 several places. The surrounding ovarian tissue, which is markedly vascular and 

 degenerate, shows infiltration in places, especially where it is stretched over the 

 large clot. No fibrous layer bounds the implantation cavity, as in the case re- 

 ported by Seedorff. The ovarian stroma merely is slightly condensed here and 

 there, and in places contains areas of hyaline degeneration, the exact origin of 

 which could not be definitely determined. A few of these are found near the thin 

 bounding layer of the ovarian stroma, but no lutein layer or even luteal cells could 

 be recognized. The only objects seen which might be regarded as possibly luteal 

 in origin are two microscopic rhomboidal areas which lie near a small depression 

 upon the surface, indicated in figure 167. These areas, which were covered by a 

 very thin layer of ovarian stroma only, were made up of parallel, degenerate, 

 slightly separated cords consisting of a syncytium containing numerous rather 

 pycnotic, unequal-sized nuclei. No pigment was seen in these areas, and were it 

 not for the arrangement of the syncytial cords, one would not be reminded, even 

 remotely, of a possible luteal origin. Although the germinal epithelium was wholly 

 absent in the areas examined, these questionable areas nevertheless may have 

 had such an origin. In the absence of lutein cells the present case corresponds to 

 those of Freund and Thome and others, and stands in marked contrast to the cases 

 of van Tussenbroek, Franz, Anning and Littlewood (1901), and Thompson (1902). 

 As in the case of Seedorff and others, no decidua was present, and nothing sug- 

 gestive of an attempt at decidual formation, as reported by Franz, Webster (1904, 

 1907), Kantorowicz (1904), and Caturani (1914), was seen in the portions examined. 



In describing his case, Seedorff declared that in some places of contact be- 

 tween the fetal and maternal tissues he could not discriminate between tropho- 

 blast and connective-tissue cells which looked like decidual cells and lutein cells. 

 It is interesting that Seedorff also spoke of villi which were almost filled with Lang- 

 hans cells, an observation which naturally makes one wonder whether by any 

 possibility these could have been Hofbauer cells. 



The preserved ovarian tissue which was found near the amputation stump 

 contained hemorrhagic follicles, as observed also by Mall and Cullen (1913). A 

 Graafian follicle 3 mm. in section, shown in figure 166, protruded above the rest 

 of the stroma and was quite mature. The presence of this follicle might be taken 

 as an evidence of the occurrence of ovulation during pregnancy, were it not for 

 the fact that the presence of so degenerate a conceptus shows that as far as any 

 effect upon the maternal organism was concerned, the pregnancy virtually had 

 been terminated long before. That both ovulation and menstruation can and do 

 return after the death of an ovarian conceptus, but before its removal from the 

 ovary, is illustrated also by cases in the literature, especially by that of Norris 

 (1909). One must assume, however, that few, if any, surviving fetal elements 

 can be present under these circumstances. This conclusion also would seem to be 

 confirmed by the remarkable case of Sencert and Aron (1919). These authors 

 reported a case of ovarian pregnancy in which nothing but a portion of an umbilical 

 cord 5 mm. long, containing Wharton's jelly, two arteries and a vein, and what was 



