REPRODUCTIVE ORGANS OF THE MALE. 715 



phied papillae covered with epithelium. Sometimes the epithelial layers 

 become thick and horny, forming large, dense projections. 



Fibroma diffusum, or elephantiasis of the prepuce, may occur, leading 

 to great thickening. It is due to a diffuse growth of fibrous tissue in the 

 cutis. Lipoma, angioma, circumscribed fibroma, and sebaceous cysts may oc- 

 cur in the penis. Carcinoma is usually of the epitheliomatous type. It 

 is most frequent in the prepuce and glans penis. It may have the form 

 of a flat ulcer, or of infiltrating, ulcerating nodules, or it may be papil- 

 lary. Such growths may attain great size, ulcerate, or undergo a variety 

 of inflammatory changes. Carcinoma may involve the entire skin of the 

 penis or may invade deeper parts. The inguinal glands may be involved. 

 Distant metastases are not frequent. 



Medullary or glandular carcinoma of the penis is not common. It 

 may be secondary to carcinoma in some other part of the body. 



Dermoid tumors of the penis are of occasional occurrence. ' 



Calcification and Ossification of the connective tissue of the corpora 

 cavernosa sometimes occur. Large and small preputial calculi are occa- 

 sionally found between the prepuce and the glans. These may be formed 

 in situ, may come from the bladder or from without, and may later in- 

 crease in size. 



The Scrotum. 



The skin of the scrotum is subject to the various forms of lesions 

 which may occur in any part of the integument. 



Elephantiasis of the scrotum consists in the main of a development of 

 new connective tissue in the cutis, which is sometimes accompanied by 

 dilatation of the lymph-vessels ; thus the thickened scrotum may form a 

 large tumor, often rough upon the surface, which may entirely cover in 

 the penis. 



TUMORS. 



Lipoma and fibroma occur. Epitheliomata, in the form of flat or 

 papillary ulcerating tumors, are of frequent occurrence among chimney 

 sweepers, and may lead to extensive ulcerations of the adjacent parts and 

 involvement of neighboring lymph-nodes. 



Dermoid Cysts and Teratomata of the scrotum are not uncommon. In 

 very rare cases tumors containing a considerable portion of a fostal skele- 

 ton have been found in the scrotum. Occasionally the skin of the scrotum 

 is beset with numerous larger and smaller sebaceous cysts, which raise 

 the surface into little globular or wart-like projections. 



The Testicles. 



Malformations . 



Absence of both testicles, either with or without absence of the epididymides, 

 spermatic cords, and vesiculae seminales, occurs in rare cases. The scrotum is only indi- 



1 Gerulanos. Deut. Zeits. f. Chir., Bd. lv., p. 326. 



