THE PSEUDOMYCETOMAS 



2147 



The differentiation from mycetoma is not diffiicult, as the grain 

 is readily found in this growth, which it certainly is not in a para- 

 mycetoma. 



The differentiation from malignant growth is at the same time 

 very easy and very difficult. Very easy because at once the speci- 

 men appears somewhat different from the typical malignant growth 

 simulated, and very difficult because it may require prolonged 

 search before definite evidence of the presence of a fungus is found. 



Prognosis. — -This depends upon the site and age of the tumour 

 and its association with malignant characters or not. If the last 

 feature is absent, and the growth is small and can be completely 

 removed, the prognosis is good, otherwise it is bad. If glandular 

 excision is performed, the presence or absence of infection is of the 

 utmost prognostic value. 



Treatment. — -The only known satisfactory treatment is the early 

 and complete removal of the growth associated with glandular 

 excision. 



THE PSEUDOMYCETOMAS. 



Definition. — A pseudomycetoma resembles a mycetoma clinically 

 in the presence of swelling, ulceration, and discharge, but differs 

 therefrom in the absence of grains, and from a paramycetoma in 

 the absence of eosinophile bodies. 



Fig. 849. — Pseudomycetoma of Frambcesial Origin. 



History. — The name pseudomycetoma was first used by Castellani 

 to indicate a peculiar tertiary condition of yaws, which he described 

 as clinically somewhat resembhng mycetoma. The term was adopted - 

 by us in the second edition of this work. 



Remarks.^ — This condition is now well-known to occur in the 

 tertiary stage of framboesia tropica (yaws), and is not unfrequently 

 seen in Ceylon. Breinl, in New Guinea, has described a similar 



