SOLID TUMORS IN THE OVARY. 121 



tumor, as large as a child's head, in the right ovary ; it can be 

 moved to the right or left, and is easily rotated on its axis. 



Carcinoma of the ovary is of somewhat more frequent occur- 

 rence, but it also is rare. Medullary carcinoma is almost the only 

 form that occurs here ; scirrhous and colloid cancer of the ovary 

 are very rare. From complication with formation of cysts, carci- 

 noma of the ovary may form immense tumors. This neoplasm 

 almost always extends over large portions of the peritonaeum. 



Occasionally we may decide with more or less certainty that 

 there is not a simple cyst of the ovary, from the hardness of the 

 tumor, and from the course of the affection differing from that usual 

 to ovarian cysts. In most cases the diagnosis is obscure. If ascites 

 accompany a nodular tumor of the ovary, and we can discover no 

 other cause for it, the chances are that there is cancerous degenera- 

 tion. In one case of excessive ascites I made the diagnosis of car- 

 cinoma of the peritonaeum starting from the ovary, even before 

 feeling the nodular tuinor of the ovary (which was rendered very 

 perceptible by tapping), by excluding other causes of ascites, and 

 from the account the patient gave of having had pain in the lower 

 part of the right side of the abdomen and right thigh, as well as of 

 varicose veins of the right leg that had preceded the abdominal dis- 

 tention . The treatment of these ovarian tumors is the same as that 

 of ovarian cysts ; but the hope of success is even less than it is in 

 the latter disease. 





