THE REPRODUCTIVE ORGANS OF THE FEMALE. 681 



boidal cells. It may develop in irregular papillary masses (Fig. 431), 

 the more or less abundant fibrous stroina being covered with irregular 

 layers of epithelium (Figs. 432 and 433). The new growth may project 



FIG. 435. ADENOMA OF THE UTERUS. 



Showing the extension of the new growth into the deeper portions of the cervix. The section shows 

 one side of the cervix. The epithelium over the portio vaginalis is intact ; in the right upper region in the 

 figure is seen a ragged erosion of the epithelium lining ttie cervical canal and the exposure of a portion of 

 the tumor growth upon the free surface. 



from the inner surface of the uterus in the form of ragged lobular 

 masses (Fig. 434), or it may infiltrate the submucous tissues (Fig. 435). 

 Or growth in both directions may occur at once. 



The topographical features and clinical stories of many adenomata 

 of the uterus are identical with those of the infiltrating and ulcerating 

 carcinoinata. 



Carcinoma. 1 The carcinomata of the uterus commence most frequently 

 in the cervix and portio vaginalis, and the most common form is the 

 epithelioina. The growth of epitheliomata of the cervix uteri proceeds 

 under three tolerably distinct forms which, however, frequently merge 

 into one another. 



1. The flat, ulcerating epithelioma. This form of cancer commences 

 as a somewhat elevated, flat induration of the superficial layers of the 

 cervix, sometimes circumscribed, sometimes diffuse. This induration is 

 due to the growth of plugs and irregular masses of epithelial cells into 

 the underlying tissue (Fig. 436). Ulceration usually commences early 

 1 Consult for details Cullen, "Carcinoma of the Uterus," 1900. 



