538 TUMORS. 



termed lenticular cancer (cancer en cuirasse, Velpeau), which 

 starts from a cancer nodule of the breast, and in a comparatively 

 short time invades all the soft tissues of the pectoral wall, the 

 shoulders, the upper extremities, we look in vain for the epithe- 

 lial cancer-nests, the main bulk of the tumor being constructed 

 like a very malignant globo-myeloma. Secondary tumors in 

 internal organs, chiefly the lungs and the liver, often exhibit 

 no distinct epithelial nests, but only the structure of globo- 

 myeloma. 



Medullary cancer may appear primarily in any organ or tissue 

 of the body, although unquestionably, in the majority of cases, 

 it starts from organs which contain epithelial formations as 

 anatomical constituents, and are, therefore, glandular. 



The localities where primary cancer most frequently develops 

 are : the female breast, the cervical portion of the uterus, and the 

 stomach. According to Virchow the order in which the organs 

 are invaded by malignant growth in general is the following : 

 Stomach in 34.9 per cent. ; uterus, vagina, etc., in 18.5 per cent. ; 

 large intestine and rectum in 8.1 per cent. ; liver in 7.5 per 

 cent. ; face, lips in 4.9 per cent. ; female breast in 4.3 per cent, 

 of the cases ; the sum total being 78.2 per cent, of fatal cases 

 caused by malignant tumors. 



The classification of cancers is, as here shown, a simple matter,, 

 but some pathologists are anxious to construct a large number 

 of species and sub- varieties of cancer, with corresponding Greek 

 and Latin denominations. The term "plexiform" is suitable 

 for the designation of epithelial tracts branching and connect- 

 ing within the connective tissue. It may be stated as a general 

 rule that the larger the amount of connective tissue in a certain 

 bulk of the tumor, and the smaller the number of epithelial 

 nests, the harder will be its consistency and the less its malig- 

 nancy. On the contrary, the smaller the amount of connective 

 tissue, the larger the number of epithelial nests, the greater 

 will be its malignancy. Myxomatous connective tissue between 

 the epithelial nests necessarily lessens the consistency of the 

 tumor without increasing its malignancy. 



An important point for the determination of the degree of 

 the malignancy of cancer is the presence of small, shining, globu- 

 lar elements in the connective tissue. Larger numbers of these 

 formations invariably indicate a rapid growth of the tumor, and 

 if occurring in a very large number they render the tumor a 

 myeloma. This condition is only found in the worst types of 



