Bemirrent Fibroid Tumours. 563 



27th August 1870 she applied to Professor Spence again on account of a 

 second growth in her breast near the cicatrix of the last operation. It had 

 been gi'owing for some months, and had reached the size of a small melon. 

 This was also removed successfully. On 2nd June 1871 Professor Spence 

 was called to see her. She was then in a moribund condition from broncho- 

 pneumonia and pericarditis, with inability to swallow even fluids. There 

 was a discharging ulcer in her right arm-pit. This had been due to a 

 swelling which formed near the cicatrix of the last operation, and had 

 then burst and discharged matter. At the posi-mortem examination 

 numerous small white nodules were found in the left pleural sac, varying 

 from the size of a millet seed to that of a pea. There was a fibrous 

 structure of the oesophagus near the stomach, and three fibroid tumours 

 attached to the uterus. It is difficult to say whether the axillary ulcer 

 was due to a softening tumour or not. Possibly a recurrent tumour had 

 given rise to the nodules in the pleura. This case is referred to by Sir 

 James Paget in his lectures on Pathology. 



The specimen shows a somewhat uniform texture without 

 any capsule separating it from the fasciae round about. On the 

 skin are well seen the cicatrices due to former operations. 



G. C. 1831 



Presented hy A. D. Maclagan, F.R.C.S.E., 21st October 1836. 



9. 59. Recurrent Fibroid Tumour. — Portion of a left arm 



after amputation, showing several sarcomatous tumours laid 

 open — in spirit. 



James D., aged 78, was admitted to the Royal Infirmary on 13th 

 August 1892, complaining of lumps in his forearm, which were sometimes 

 painful. 



About 18 months before admission, the patient's daughter had drawn 

 his attention to a swelling on his left forearm, almost as big as the present 

 one. He had been quite unaware of its presence up to that time. It was 

 situated on the inner aspect of the forearm on its upper third. The mass 

 grew much larger in a short time, and was removed by Dr Dickson, 

 Carnoustie, on 26th July 1891. The wound had just healed, when a second 

 lump made its appearance, and this, he thinks, did not grow so quickly as 

 the first, and did not attain the same size. It was also removed by Dr 

 Dickson in November 1891. Another growth appeared, and was removed 

 in March 1892. These fresh growths appeared in the region of the first, 

 close to the wound of operation. About a month or six weeks after the 

 last operation another lump appeared, this being rather higher up the 

 forearm, according to the patient, than the previous ones. The growth 

 was not very rapid at first, but during the last mouth had grown very 

 rapidly. The patient was recommended by Dr Dickson to go to the 

 Edinburgh Infirmary, which he did. 



