No. 382.) REVIEWS OF RECENT LITERATCRE. 799 
colon throughout nearly its entire length, as well as to the adjacent 
peritoneum. According to Dr. W. F. McNutt, who performed the 
operation, the abdominal veins were dilated, but the tumor cleaved 
out easily and apparently completely. No large vessels were encoun- . 
tered during the removal beyond “such as run in brittle adhesions,” 
though the peritoneal surface, from which the growth was removed, 
was left raw and bleeding. 
The tumor “ contained tissues and portions of organs correspond- 
ing in embryonic origin to all the germinal layers. Corresponding 
to the epiblast there were skin with cutaneous organs and append- 
ages, central nervous system, peripheral nerves, and the rudiments 
of eye structure. 
“The hypoblast was represented by mucous glands, tubes, and 
cysts, with epithelial lining and surrounded by smooth muscle. The 
mesoblastic tissues consisted of bone, cartilage, white fibrous tissue, 
yellow elastic tissue, mucoid connective tissue, adipose tissue, smooth 
muscle fiber, and blood vessels.” 
The nervous tissue was in large quantity, but no ganglionic cells 
were made out with certainty. Of the eye only portions of the 
pigmented layer of the retina, and possibly parts of the sclera, were 
found ; but the former were so distinct and characteristic that both 
observers agree in considering error of identification as impossible. 
Highly significant concerning this tissue is the fact that “similar 
polygonal pigmented cells are to be seen irregularly distributed 
through the sections, sometimes apparently in solid portions of the 
tissues, sometimes lining small irregular slit-like spaces, and in one 
instance lining a space which is continuous with the cavity lined 
by ependymal epithelium, which probably corresponds to brain 
ventricle.” 
The blood in the vessels had all the characteristics of adult blood. 
No nucleated red cells were found. No trace of a heart was 
present. 
After the operation the patient seemed to do well for a time, but 
in about a month it was found that the tumor was growing again, and 
it was removed a second time. The recurrent growth did not come 
away whole as did the first, as it was softer, more friable, and 
involved the peritoneum both more widely and more intimately than 
did the first. Like the original, “it contained tissues from all three 
germ layers. Indeed, all the structures met with in the original 
tumor could be found in various parts of the tissue removed at the 
second operation.” 
