358 Diseases of Bone. 



6.391. Ivory Exostosis of Nasal Cavity.— Section of an. 



irregular mass of exceedingly dense bone, from the right nasal 

 cavity of a man aged about 40. 



For many years the patient had suffered from inconvenience and 

 discharge from his right nostrih Some polypi had been removed, and 

 about a year before this mass was taken away it had been recognised as 

 probably a rinolith. After one or two unsuccessful attempts to remove it 

 while the patient was under chloroform, this mass was finally extracted, but 

 not until the anterior nares had been freely exposed, and their margins- 

 enlarged with gouge forceps. During this operation an attempt was- 

 made to divide this mass, and the marks of the saw are shown in the 

 specimen. Had the saw-cut been completed, the removal would have 

 been easier. 



The patient died of septic meningitis about a week after the 

 operation, and at the ^ws^j«orfe//t examination it was found that the mass- 

 had pressed through the cribriform plate of the ethmoid bone, and had 

 entered the cranial cavity. On this account the operation had the more- 

 easily set up the fatal meningitis. 



The section shows the dense ivory-like character of the 

 growth. On microscopic examination it was found to be com- 

 posed of very dense bone. 



It had no doubt originally grown from the ethmoid, but 

 it must have afterwards necrosed, for it was quite loose within 

 its cavity at the time of the operation. G. C. 3273. 



Presented by A. G. Miller, F.R.C.S.E. 



6. 392. Ivory Exostosis of Nasal Cavity.— Plaster cast of 



the previous specimen before it was sawn up. G. C. 3274. 



6. 393. Very large Fibro-Osseous Tumour of the Lower 



End of Femur.— Section of the lower half of a femur* 

 with the above tumour growing from it — in spirit. 



The patient, a woman, aged 33, was admitted to Professor Chiene's 

 ward in October 1890. 



Five or six years before admission, she thinks she sustained a sprain 

 of the knee, and ever since then the knee has been swollen, getting 

 gradually larger, but never painful. The patient has never been laid up, 

 and only had difficulty in walking for the first time two months before 



