Sarcomatous Cartilaginous Tumours. 343 



enlargements. The first, second, and fifth metacarpal bones 

 have had small growths attached to them. G. C. 2269. 



6. 365. Chondro-sarcoma of the Thumb.— Section of a 



thumb — in spirit — showing a chondro-sarcomatous tumour 

 growing from the first phalanx. 



The man, aged 51, was admitted to the Royal Infirmary, Edin- 

 burgh, in December 1891. His family history was good, and he had 

 previously been quite healthy and temperate. 



"Seven years ago," while holding a horse with a rope, the rope got 

 twisted round his thumb and hurt it. The thumb was sore for several 

 days after this, but did not swell. This was in spring ; during the 

 summer it felt stiff, and in the following winter the first phalanx swelled 

 up from what was considered to be rheumatism. During the following 

 winter it again became at times sore and swollen. The swelling was 

 red, and the veins over it were distended. It came and went more 

 frequently, and seemed to be worse on exposure to cold. It soon continued 

 lo be painful even when there was no swelling. This intermittent 

 swelling continued for four years, when he noticed a small lump attached 

 to the outer side of the first phalanx. The lump was bluish and soft ; it 

 ■was very painful, and he thought it was going to form matter. It, 

 however, continued to grow without coming to a head. Eighteen months 

 :ago it was opened, and only blood came out, and last August it was 

 opened again, with the same result. The thumb was amputated and the 

 patient shortly afterwards went home. 



After section the tumour was found to have originated in 

 the front of the first phalanx, and to have expanded the bone 

 for a short distance laterally, but there was no shell of the bone 

 over the main piece of the tumour. The joints at each end of 

 the phalanx were not affected. The tumour mass was of firm 

 consistence, except towards the margins, where it was soft and 

 reddish, haemorrhages having taken place into the tissue at these 

 parts. The main mass of the tumour presented a gelatinous 

 appearance, with a network of dense white material, apparently 

 cartilage of firmer consistence than the rest, and with calcareous 

 nodules interspersed. 



Microscopic examination showed it to be chondro-sarcoma 

 (round-celled) with some myxomatous degeneration. 



G. C. 3358. 

 Presented hy John Duncan, F.R.C.S.E., December 1891. 



