Anomalies and Curiosities of Medicine [483]
complete extirpation of the thyroid gland, except for malignant disease, is unjustifiable. Partial extirpation of the thyroid gland is still practiced; and Wolfler has revived the operation of ligating the thyroid arteries in the treatment of tumors of the thyroid gland.
Fibromata.--One of the commonest seats of fibroma is the skin. Multiple fibromata of the skin sometimes occur in enormous numbers and cover the whole surface of the body; they are often accompanied by pendulous tumors of enormous size. Virchow called such tumors fibroma molluscum. Figure 237 represents a case of multiple fibromata of the skin shown by Octerlony. Pode mentions a somewhat similar case in a man of fifty-six, under the care of Thom. The man was pale and emaciated, with anxious expression, complaining of a tumor which he described as a "wishing-mark." On examination he was found to be covered with a number of small tumors, ranging in size from that of a small orange to that of a pin's head; from the thoracic wall over the lower true ribs of the right side was situated a large pendulous tumor, which hung down as far as the upper third of the thigh. He said that it had always been as long as this, but had lately become thicker, and two months previously the skin over the lower part of the tumor had ulcerated. This large tumor was successfully removed; it consisted of fibrous tissue, with large veins running in its substance. The excised mass weighed 51 pounds. The patient made an early recovery.
Keloids are fibromata of the true skin, which may develop spontaneously or in a scar. Although the distinction of true and false keloid has been made, it is generally discarded. According to Hebra a true typical keloid is found once in every 2000 cases of skin-disease. It is, however, particularly the false keloid, or keloid arising from cicatrices, with which we have mostly to deal. This tumor may arise from a scar in any portion of the body, and at any age. There seems to be a disposition in certain families and individuals to keloid-formations, and among negroes keloids are quite common, and often of remarkable size and conformation. The form of injury causing the cicatrix is no factor in the production of keloid, the sting of an insect, the prick of a needle, and even the wearing of ear-rings having been frequent causes of keloid-formations among the negro race. Collins describes a negress of ninety, born of African parents, who exhibited multiple keloids produced by diverse injuries. At fourteen she was burned over her breasts by running against a shovelful of hot coals, and several months later small tumors appeared, which never suppurated. When a young girl a tumor was removed from the front of her neck by operation, and cicatricial tumors then spread like a band encircling one-half her neck. There were keloids over her scapulae, which followed the application of blisters. On her back, over, and following the direction of the ribs, were growths attributed to the wounds caused by a flogging. This case was quite remarkable for the predisposition shown to keloid at an early age, and the variety of factors in causation.
About 1867 Duhring had under his observation at the Philadelphia Hospital a negro whose neck was encircled by enormous keloids, which, although black, otherwise resembled tomatoes. A photograph of this remarkable case was published in Philadelphia in 1870.
A lipoma is a tumor consisting of adipose tissue. When there is much fibrous tissue in the tumor it is much firmer, and is known as a fibro-lipoma. Brander describes a young native of Manchuria, North China, from whom he removed a fibro-lipoma weighing 50 pounds. The growth had progressively enlarged for eleven years, and at the time of extirpation hung as an enormous mass from beneath the left scapula. In operating the tumor had to be swung on a beam. The hemorrhage was slight and the patient was discharged in five days.
The true lipoma must be distinguished from diffuse accumulations of fat in different parts of the body in the same way that fibroma is distinguished
Fibromata.--One of the commonest seats of fibroma is the skin. Multiple fibromata of the skin sometimes occur in enormous numbers and cover the whole surface of the body; they are often accompanied by pendulous tumors of enormous size. Virchow called such tumors fibroma molluscum. Figure 237 represents a case of multiple fibromata of the skin shown by Octerlony. Pode mentions a somewhat similar case in a man of fifty-six, under the care of Thom. The man was pale and emaciated, with anxious expression, complaining of a tumor which he described as a "wishing-mark." On examination he was found to be covered with a number of small tumors, ranging in size from that of a small orange to that of a pin's head; from the thoracic wall over the lower true ribs of the right side was situated a large pendulous tumor, which hung down as far as the upper third of the thigh. He said that it had always been as long as this, but had lately become thicker, and two months previously the skin over the lower part of the tumor had ulcerated. This large tumor was successfully removed; it consisted of fibrous tissue, with large veins running in its substance. The excised mass weighed 51 pounds. The patient made an early recovery.
Keloids are fibromata of the true skin, which may develop spontaneously or in a scar. Although the distinction of true and false keloid has been made, it is generally discarded. According to Hebra a true typical keloid is found once in every 2000 cases of skin-disease. It is, however, particularly the false keloid, or keloid arising from cicatrices, with which we have mostly to deal. This tumor may arise from a scar in any portion of the body, and at any age. There seems to be a disposition in certain families and individuals to keloid-formations, and among negroes keloids are quite common, and often of remarkable size and conformation. The form of injury causing the cicatrix is no factor in the production of keloid, the sting of an insect, the prick of a needle, and even the wearing of ear-rings having been frequent causes of keloid-formations among the negro race. Collins describes a negress of ninety, born of African parents, who exhibited multiple keloids produced by diverse injuries. At fourteen she was burned over her breasts by running against a shovelful of hot coals, and several months later small tumors appeared, which never suppurated. When a young girl a tumor was removed from the front of her neck by operation, and cicatricial tumors then spread like a band encircling one-half her neck. There were keloids over her scapulae, which followed the application of blisters. On her back, over, and following the direction of the ribs, were growths attributed to the wounds caused by a flogging. This case was quite remarkable for the predisposition shown to keloid at an early age, and the variety of factors in causation.
About 1867 Duhring had under his observation at the Philadelphia Hospital a negro whose neck was encircled by enormous keloids, which, although black, otherwise resembled tomatoes. A photograph of this remarkable case was published in Philadelphia in 1870.
A lipoma is a tumor consisting of adipose tissue. When there is much fibrous tissue in the tumor it is much firmer, and is known as a fibro-lipoma. Brander describes a young native of Manchuria, North China, from whom he removed a fibro-lipoma weighing 50 pounds. The growth had progressively enlarged for eleven years, and at the time of extirpation hung as an enormous mass from beneath the left scapula. In operating the tumor had to be swung on a beam. The hemorrhage was slight and the patient was discharged in five days.
The true lipoma must be distinguished from diffuse accumulations of fat in different parts of the body in the same way that fibroma is distinguished