OVARIAN CYSTS 519 



is entirely unavailable for metabolism, at least in all cases, but in 

 malignant fatty tumors this seems to be true. Hirsch*^ and Wells 

 have studied such a tumor in which, despite most complete exhaus- 

 tion of the fat from the normal fat depots, about two pounds of fat 

 and four and one-half pounds of protein were stored up in the growing 

 tumor. This tumor was an edematous retroperitoneal lipo-sarco?na, 

 weighing G9 pounds (the heaviest solid tumor on record) and its 

 chemical composition is given below as compared with the composition 

 of granulation tissue (castration granuloma of swine) . 



Fibro lipo 



sarcoma. Granuloma, 



per cent. per cent. 



Alcohol ether residue 6 . 53 15 . 84 



Alcohol ether extract 2.94 2.28 



Total soUds 9.47 18.12 



Water 90.53 81.88 



Alcohol ether residue 

 (per cent, of solids) 



Total protein 66.91 91.16 



Protein sulphur . 65 . 33 



Protein phosphorus . 44 0.31 



Total Purine Nitrogen 0. 13 0. 07 



Lipins contained, 

 per cent. 



Total nitrogen 0.17 . 09 



Total sulphur . 13 . 05 



Total phosphorus 0.19 . 09 



(e) Ovarian cyst contents have been studied more than almost 

 any other tumor products, because in their gelatinous or slimy sub- 

 stance are contained numerous interesting forms of proteins, many 

 of which are combined with carbohydrates and related to the true 

 mucins. These substances are frequently referred to under the names 

 of pseudomucin, paralbumin, metalbumin, and ovarian "colloid," and 

 belong to the class of "mucoids."^° In view of the fact that the flu- 

 ids in the Graafian follicles of the ovary do not contain these particu- 

 lar forms of protein, their presence in cysts derived from adventitious 

 structures (Pfliiger's epithelial tubes) suggests a specific form of meta- 

 bolism on the part of the epithelium of these structures. 



Serous cysts, formed by dilation of Graafian follicles, usually are 

 small in size, and the contents resemble those of the normal follicles 

 (Oerum),^^ consisting 'of a serous fluid with a specific gravity usually 

 from 1.005 to 1.014 (occasionally 1.020 or more), and containing 

 1.0-4.0 per cent, of solids. Occasionally in these cysts the contents 

 become solidified through absorption of the water, and a gelatinous or 

 glue-like "colloid" content results. Mucoids are never present (Pfan- 

 nenstiel).^- 



89 Amer. Jour. Med. Sci., 1920 (159), 356. 



9" Concerning mucoids see Mann's "Chemistry of the Proteins," 1906, pp. 541- 

 551. 



" See Malv's Jahresbericht, 1884 (14), 459. 



92 Arch. f.^Gynsek., 1890 (38), 407 (literature). 



