512 TUMORS. 



attached to the tumor only after injuries from without f. i., 

 friction of the clothing or long-continued pressure. Under these 

 circumstances ulceration even may be produced, which is char- 

 acterized by the offensive odor of discharge. 



In the subcutaneous tissue both solitary and multiple fatty 

 tumors occur $ they may be circumscribed or diffused. Pedun- 

 culated and diffused fatty tumors are exceptional ; the latter are 

 of a softer consistency, and are attached to the skin by means of 

 dense, fibrous connective tissue. 



Lipoma is painful only when nerve branches are involved in 

 the growth, and disturbance of functions is caused only by its 

 size and weight. The growth is slow but almost indefinite, as 

 there have been observed fatty tumors of twenty to thirty 

 pounds. The larger the tumor the more marked is its lobular 

 structure. Not infrequently calcareous deposition is found in 

 the connective-tissue frame, and occasionally, though rarely, 

 ossification. 



Lipoma occurs combined with : 



Hypertrophy of a finger, a toe, or the entire hand or foot ; 



Myxoma, fibroma, and myxo-fibroma, producing tumors of 

 the skin, termed " naevus lipomatodes " ; 



Cavernous angioma (Billroth), when especially the veins are 

 ectatic in a high degree ; 



Myeloma, usually myxo-myeloma of the subcutaneous tissue. 



Peculiar branching growths of serous membranes, especially 

 of the knee-joint, which consist of delicate papillary vegetations 

 of connective tissue, whose meshes contain fat-tissue, are con- 

 sidered as formations of lipoma (1. arborescens). Localized, 

 diffuse new formation of fat occurs in the female breast, which, 

 on one or on both sides, may reach an enormous size and weight. 



7. ANGIOMA. VASCULAR OR ERECTILE TUMOR. 



The characteristic feature of angioma is an abundant supply 

 of blood-vessels arterial, venous, or capillary. This causes its 

 erectility i. e., its swelling on a spontaneous engorgement of 

 the vessels. Such tumors yield readily to pressure, but as soon 

 as the pressure is removed they refill. In former times many of 

 these tumors were termed " teleangiectasis," as they were thought 

 to be due to a mere dilatation of the vessels ; now we are ac- 



