392 . Diseases of Bone. 



and rich network running on the face of the tumour. The tumour is split, 

 and forcibly torn asunder, so as to show the tibia within it. The periosteiini 

 has separated from the bone and remains attached to the tumour. The 

 surface of the bone is left rough and indented by the pressure of the 

 tumour. The structure of this tumour is the same with those we have 

 seen, only that it retains a great deal more of the cartilaginous firmness." 



B. C. I. 6. M. 26. 



CANCER (secondary) OF BONE. 



6. 464. Epithelioma invading" the Tibia. — Section of a tibia 



and adjacent soft parts, injected with carmine and gelatine — in 



spirit, illustrating the above. 



About thirty years before the amputation, the patient, a man aged 

 50, had sustained a compound fracture of the leg below the knee, Dr 

 Gillespie, under whose care he then was at the Old Royal Infirmary, 

 advised amputation, but the patient declined. After a long illness, he 

 recovered, but ever since had suffered from chronic pains in his tibia, and 

 his ankle remained fixed in the extended position. The scar which had 

 resulted from the injurj' alternately healed and broke out from time to 

 time until lately, when it began to spread jiersistently, and became 

 exuberant. Epithelioma of the scar was diagnosed, and the leg was 

 amputated. The glands in his groin were found enlarged, and were 

 excised at the same time. When seen about a j'ear after the operation, he 

 was free from any return in the stump or groin, and was in excellent 

 health. 



The preparation illustrates the warty character of gran- 

 ulations which have become epitheliomatous, while the section 

 shows how the epithelioma has been spreading downwards to 

 the bone and eating into it. G. C. 3107, 



Presented hy A. G. Miller, F.R.C.S.E., 1889. 



6. 465. Epithelioma and Chronic Suppuration eroding* and 

 destroying" the Tibia.— Lower three-fourths of a left tibia 

 and fibula — macerated, illustrating the above. 



The leg was amjiutated for " spontaneous" fracture. As a boy, the 

 j)atient, a man aged 45, had suffered from suppurative osteo-myelitis and 

 periostitis ending in necrosis. The original wound had healed after some 

 dead bone had been removed, but after an interval of several years had 

 Virokpu out again. More bone then came away, and the wound healed, 



