Primary cancer of the Fallopian tube : with a second series of tables of reported cases (no. 63 to no. 100) / by Alban Doran.

  • Doran, Alban H. G. (Alban Henry Griffiths), 1849-1927.
Date:
1910
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Licence: In copyright

Credit: Primary cancer of the Fallopian tube : with a second series of tables of reported cases (no. 63 to no. 100) / by Alban Doran. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    Bickersteth case of papilloma of tlie tube in order to make sure that it was not malignant.* I particularly did not wish to rush into print, the more so as having written several papers on primary cancer of the Fallopian tube, it might be thought that I was too eager to add, under my own name, a case hurriedly investigated and of doubtful authenticity. I left the examination to Mr. Targett, who had noted the relations of the tumour when he assisted me in removing it, and who examined it with great care, without bias and taking nothing for granted. Since then I have studied and reviewed the work of others; I have particularly borne in mind Zangemeister s advice about care in investigating the primary source of a papillo- matous new growth when it involves both the tube and the ovary. After these ten years of deliberation I have come to the conclusion that I may feel justified in adding my case to the first hundred of reported instances of primary cancer of the Fallopian tube. My attention, whilst from time to time I studied this case, was turned to some observations by the late Professor Pfannenstiel on two cases of tubo-ovarian cyst which, very probably, were identical with my own,f but the primary seat of the malignant tumour is doubtful in both. In the first, the patient, whose age is not given, had a large unilateral tubo-ovarian cyst, as big as a child’s head. The Fallopian tube opened widely into the ovarian part of the cyst. A big mass of new growth, papillomatous adeno-carcinoma, projected from the ostium of the tube into the ovarian cavity, but, excepting close to the tube, there were no malignant growths on or in the walls of that cavity. The patient died a year later, after an operation for the removal of some cancerous supra-clavicular glands. In Pfannenstiel’s second case the patient was a nullipara, aged 58. She was the subject of bilateral tubo-ovarian cyst. The cysts were remarkably symmetrical in character; the ovarian portion was unilocular. The orifice of the Fallopian tube was distended by a mass of malignant papilloma as big as a walnut, which projected into the ovarian portion of the tumour, which bore a few minute papillomatous growths. The patient, let it be remembered, died eight weeks after the removal of these malignant cysts, and then the uterus and also the stomach were found to be the seat of cancer. Pfannenstiel reasonably concludes that, as far as the tubo-ovarian cyst is concerned, the cancer originated in the tubal portion in both his cases. In the first the tube was very probably the primary seat of the growth, but in the second it might well have been infected from elsewhere. Still it might, after all, have been the primary seat. Unfortunately the clinical history is somewhat defective, nor * The patient was living twenty-three years after the operation. See “ Diseases of the Fallopian Tube” in Allbutt and Eden’s System, of Gynaecology (1906), p. 504. T Pfannenstiel, Die Erkrankungen des Eierstocks und des Nebeneierstocks,” Veit's Handbuch der Gynakologie, Vol. iii, Pt. 1 (1898), p. 406.