Posts tagged tumor

Osteo-chondro-myxosarcoma before and after surgical intervention

Osteogenic tumors develop bone that displaces soft tissue. Osteo- means “bone”, and -genic means “to form”. In addition to the osteogenic behavior, this patient’s tumor has caused disordered cartilage (chondro-) and mucous membrane (myxo-) growth.

The case report states that it took “many” surgeries to completely remove the tumor and partially reconstruct the jaw, but that the patient lived a further 8 years after removal, and experienced no recurrence of the tumor in that time. While his vision suffered, as the left eye was unsalvagable, and his speech was impeded by both the incomplete jaw reconstruction and the excess skin remaining on the face, he was able to hold down a steady job and communicate. He was reported to be of “average-to-high” intelligence.

Tumors of the Jaws. Charles Locke Scudder, 1912.

Osteosarcoma of the upper jaw in 10-year-old boy Sarcomas are relatively rare tumors in humans, formed from mesenchymal cells, rather than epithelial (surface) cells. Epithelial cell tumors are called “carcinomas”. Since sarcomas are relatively uncommon, but hard tumors or cysts on the bones are not, patients are often misdiagnosed at first. In children, osteosarcomas (sarcomas of the bone) comprise approximately 2.4% of cancer cases. Most of these tumors occur in the leg bones, but around 8% originate in the jaw. The standard treatment of osteosarcoma is resection of the affected bone - that is, removal of the tumorous section, and joining together the two sections of bone on either side of the removed area. If the tumor has spread or the bone is too overtaken by it, amputation of the limb is called for. Obviously, you can’t amputate the face, but detection of facial tumors is often much less delayed than in the leg, and the removal and resection of the jaw bone is usually possible. Five-year survival rates of pediatric osteosarcoma are still one of the lowest of all the childhood cancers, at an average of 68% across all the different manifestations. However, given that the survival rate was hovering around 5-10% at the beginning of the 20th century (and that’s being generous), we’ve come a long way. Early detection and eliminating misdiagnoses of leg tumors is critical to survival in all age groups. Tumors of the Jaws. Charles Locke Scudder, 1912.

Osteosarcoma of the upper jaw in 10-year-old boy

Sarcomas are relatively rare tumors in humans, formed from mesenchymal cells, rather than epithelial (surface) cells. Epithelial cell tumors are called “carcinomas”. Since sarcomas are relatively uncommon, but hard tumors or cysts on the bones are not, patients are often misdiagnosed at first.

In children, osteosarcomas (sarcomas of the bone) comprise approximately 2.4% of cancer cases. Most of these tumors occur in the leg bones, but around 8% originate in the jaw. The standard treatment of osteosarcoma is resection of the affected bone - that is, removal of the tumorous section, and joining together the two sections of bone on either side of the removed area. If the tumor has spread or the bone is too overtaken by it, amputation of the limb is called for. Obviously, you can’t amputate the face, but detection of facial tumors is often much less delayed than in the leg, and the removal and resection of the jaw bone is usually possible.

Five-year survival rates of pediatric osteosarcoma are still one of the lowest of all the childhood cancers, at an average of 68% across all the different manifestations. However, given that the survival rate was hovering around 5-10% at the beginning of the 20th century (and that’s being generous), we’ve come a long way. Early detection and eliminating misdiagnoses of leg tumors is critical to survival in all age groups.


Tumors of the Jaws. Charles Locke Scudder, 1912.

Ecchondroma of the ilium Chondromas are benign cartilaginous tumors, which are formed by errant chondrocytes (cartilage-creating cells) creating encapsulated lobular growths either within bones (enchondromas), or outward from the bones (ecchondromas). Ecchondromas are much more uncommon than cartilage tumors which grow from within the bone. American Text-Book of Surgery. Edited by J. William White and William W. Keen, 1894.

Ecchondroma of the ilium

Chondromas are benign cartilaginous tumors, which are formed by errant chondrocytes (cartilage-creating cells) creating encapsulated lobular growths either within bones (enchondromas), or outward from the bones (ecchondromas). Ecchondromas are much more uncommon than cartilage tumors which grow from within the bone.

American Text-Book of Surgery. Edited by J. William White and William W. Keen, 1894.

Horny growth of the penis Horny growths on the skin, also known as cornu cutaneum, are keratinous skin tumors, caused by overgrowth of keratin in the dermis. Since they’re avascular (they have no bloodflow), they can be easily removed with a scalpel or sharp razor, but the underlying condition will almost always reappear if the site is not treated with radiation, chemotherapy, or (occasionally) cryotherapy. Diseases and Surgery of the Genito-Urinary System. Francis Watson, 1908.

Horny growth of the penis

Horny growths on the skin, also known as cornu cutaneum, are keratinous skin tumors, caused by overgrowth of keratin in the dermis. Since they’re avascular (they have no bloodflow), they can be easily removed with a scalpel or sharp razor, but the underlying condition will almost always reappear if the site is not treated with radiation, chemotherapy, or (occasionally) cryotherapy.

Diseases and Surgery of the Genito-Urinary System. Francis Watson, 1908.

Because maybe I shouldn’t correct/blindly accept corrections when I’m half-awake.

“-itis” means inflammation.  It’s original meaning was “of the,” because it was used at the end of an anatomical part followed by the word “nosos,” meaning illness.  So, “bursitis nosos” meant illness of the bursa. Current usage simply means inflammation of the named part, so “bursitis” is inflammation of the bursa.  


Yes yes yes. I realize that -itis means inflammation. Maybe I should have looked at my own posts, first. The person who corrected my “fever” (which would have been “pyro-”, by the way) to “swelling” wasn’t any more wrong than me, but gave a good illustration of a common misconception about what “inflammation” is.

Acute inflammation isn’t just swelling. It’s is characterized by four signs: rubor (redness), dolor (pain), calor (“fever” - hotness at the site), and tumor (swelling). I guess if you combined my original incorrect definition with the first correction, you’re halfway there?

Thanks to Dan Urbach for the interesting etymological lesson on “-itis” and everyone else who submitted posts and questions giving me the *actual* correct definition, and reminding me that sometimes I should go back and look at my definitions before hitting “post”.

Here’s Jesus trying to destroy Darwin (and failing, I might add), because I can. You have earned it.

image

[cyriak]

urbachd

Left: Large chondroma of lower left jaw in situ.
Right: Patient after recovery, post chondroma removal.

Note the tumor hung from the jacket, presumably to give a sense of size in relation to the now-healed jaw.

“Well, Thomas, it looks like you’re healing brilliantly, would you be a sport and hang your tumor on that nice jacket of yours whilst Mr. Johnson takes a photograph? Why, yes, it is saturated with preservative and dripping everywhere, but I’m sure your clothing will soak it up in a cinch. There, now, here you go - we shall string it to your shoulder. Perfect!”

Oh, you want actual information about the pictures? Well, chondromas are benign tumors, formed by cartilaginous tissues. They can form anywhere that cartilage exists, and can cause significant skeletal problems, but are not malignant, and unlike many other benign tumors, are not considered to raise the risk of cancer.

A Text-Book of Surgical Principles and Surgical Diseases of the Face, Mouth, and Jaws, For Dental Students. H. Horace Grant, 1902.

openlibrary.org

Ganglion cyst, aka “Bible bump”, aka “Let’s hit you with a large book!” Given the name “Bible cyst” or “Bible bump” from the original “treatment” of hitting the deformity with a Bible or other large book, ganglion cysts are actually considered tumors. Over 60% of the non-cancerous tumors of the hand are ganglionic, but their etiology is still not completely understood. The first description of these tumors was given by Hippocrates as “knots of tissue containing mucoid flesh”, but the first theories of their origins weren’t put forth until 1746, when one Dr. Eller wrote a descriptive paper on them. He believed that they came from synovial herniation,  or rupture through the tendon sheath, and that they were true cysts. Later theories recognized that the tumors were growths arising from ganglionic sheaths and not encysted fluids or mucoid tissues, but the old theory of “just smack it with a heavy object to burst it and make the body reabsorb it” still stuck around for a long time. Though bursting the tumor can cause temporary disappearance, this often causes more serious recurrence and additional growth. As these tissues are not cancerous, it’s generally recommended to leave them alone when they’re not interfering with normal function. Sometimes they can press against other tendons or nerves and necessitate aspiration or surgical removal, but the incidence of recurrence is over 40%. In about 75% of cases, the “cyst” will disappear or significantly decrease on its own. So, yeah, don’t let anyone convince you to let them smack you with a heavy object, just because you have one of these growths! It’s a bad idea to let people smack you with heavy objects, just as a general rule… [Source: Medscape Reference: Ganglions] [Image: Iconograms. Prof. Bockenheimer, 1913.]

Ganglion cyst, aka “Bible bump”, aka “Let’s hit you with a large book!”

Given the name “Bible cyst” or “Bible bump” from the original “treatment” of hitting the deformity with a Bible or other large book, ganglion cysts are actually considered tumors. Over 60% of the non-cancerous tumors of the hand are ganglionic, but their etiology is still not completely understood.

The first description of these tumors was given by Hippocrates as “knots of tissue containing mucoid flesh”, but the first theories of their origins weren’t put forth until 1746, when one Dr. Eller wrote a descriptive paper on them. He believed that they came from synovial herniation,  or rupture through the tendon sheath, and that they were true cysts.

Later theories recognized that the tumors were growths arising from ganglionic sheaths and not encysted fluids or mucoid tissues, but the old theory of “just smack it with a heavy object to burst it and make the body reabsorb it” still stuck around for a long time. Though bursting the tumor can cause temporary disappearance, this often causes more serious recurrence and additional growth. As these tissues are not cancerous, it’s generally recommended to leave them alone when they’re not interfering with normal function. Sometimes they can press against other tendons or nerves and necessitate aspiration or surgical removal, but the incidence of recurrence is over 40%. In about 75% of cases, the “cyst” will disappear or significantly decrease on its own.

So, yeah, don’t let anyone convince you to let them smack you with a heavy object, just because you have one of these growths! It’s a bad idea to let people smack you with heavy objects, just as a general rule…

[Source: Medscape Reference: Ganglions]

[Image: Iconograms. Prof. Bockenheimer, 1913.]

Molluscum fibrosum (Neurofibromatosis 1) neu·ro·fi·bro·ma·to·sis n. A genetic disease characterized by multiple neurofibromas and pigmented spots on the skin, sometimes accompanied by bone deformity and a predisposition to cancers, especially of the brain. Also calledmultiple neurofibroma, neuromatosis, Recklinghausen’s disease, von Recklinghausen’s disease. Image from: An Introduction to Dermatology. Norman Purvis Walker, 1905. Definition: American Heritage Medical Dictionary 2004.

Molluscum fibrosum (Neurofibromatosis 1)

neu·ro·fi·bro·ma·to·sis

n.

A genetic disease characterized by multiple neurofibromas and pigmented spots on the skin, sometimes accompanied by bone deformity and a predisposition to cancers, especially of the brain. Also calledmultiple neurofibroma, neuromatosis, Recklinghausen’s disease, von Recklinghausen’s disease.

Image from: An Introduction to Dermatology. Norman Purvis Walker, 1905.

Definition: American Heritage Medical Dictionary 2004.

Exophthalamos of the left eye due to voluminous orbital cancer Partial atrophy of the ocular muscles, partial sight still present in left eye. Right eye still functional. Cancer originated from superior levator muscle and grew back into other muscular tissues of the orbit.  This kind of cancer is much more common in adults than in children, who tend to get retinoblastomas (in the ocular nerve) more than anything. Iconographie Ophthalmologique. J. Sichel, 1858.

Exophthalamos of the left eye due to voluminous orbital cancer

Partial atrophy of the ocular muscles, partial sight still present in left eye. Right eye still functional. Cancer originated from superior levator muscle and grew back into other muscular tissues of the orbit. 

This kind of cancer is much more common in adults than in children, who tend to get retinoblastomas (in the ocular nerve) more than anything.

Iconographie Ophthalmologique. J. Sichel, 1858.

Leukemic deposits on the heart Neoplastic Diseases: A Treatise on Tumors. James Ewing, 1922.

Leukemic deposits on the heart

Neoplastic Diseases: A Treatise on Tumors. James Ewing, 1922.

Fungus Haematodes of the Arm The term “fungus haematodes” was first used in 1805 to describe a fungating mass affecting the globe of the eye that destroyed its internal organization, and was later found by the Scottish surgeon James Wardrop (whose illustration this is) to originate from the retina. After eliciting that the origin of the tumor was the retina, he also documented its metastasis to the optic nerve, brain, and in rare cases, other parts of the body (such as is seen here). Observations on Fungus Hematodes or Soft Cancer. James Wardrop, 1809.

Fungus Haematodes of the Arm

The term “fungus haematodes” was first used in 1805 to describe a fungating mass affecting the globe of the eye that destroyed its internal organization, and was later found by the Scottish surgeon James Wardrop (whose illustration this is) to originate from the retina. After eliciting that the origin of the tumor was the retina, he also documented its metastasis to the optic nerve, brain, and in rare cases, other parts of the body (such as is seen here).

Observations on Fungus Hematodes or Soft Cancer. James Wardrop, 1809.

Before and after removal of giant ovarian cyst

File under: Things I Didn’t Know You Could Survive Back Then.

Anomalies and Curiosities of Medicine. George M. Gould and Walter L. Pyle, 1900.

Tumeurs Traité des maladies de la peau. Pierre François Rayer, 1835.

Tumeurs

Traité des maladies de la peau. Pierre François Rayer, 1835.

Tuberous Sclerosis Case from German physician Richard Kothe, 1903 Tuberous sclerosis is not to be confused with tuberculosis. It’s an autosomal dominant, multi-system disorder, but almost 2/3 of cases are sporadic mutations. The periungual fibromas illustrated here are one of the key diagnostic criteria for the Tuberous Sclerosis Complex. Illustration from Wikimedia Commons

Tuberous Sclerosis

Case from German physician Richard Kothe, 1903

Tuberous sclerosis is not to be confused with tuberculosis. It’s an autosomal dominant, multi-system disorder, but almost 2/3 of cases are sporadic mutations. The periungual fibromas illustrated here are one of the key diagnostic criteria for the Tuberous Sclerosis Complex.

Illustration from Wikimedia Commons

Tumor of the left optical orbit. Highly vascularized tumor of the orbit originating from the inferior temporal bone, attaching to globe of eyeball, growing into lateral sinus, and applying extreme pressure to regional cartilage. Tumor and eye mass was removed successfully, relieving pain caused by growth. High blood loss from surgery, but nothing life-threatening. No vision loss in right eye. Fig 1. Tumor in situ. Fig 2. Tumor removed from head. Fig 3. Cross-section of tumor. Iconographie Ophthalmologique ou Description, avec Figures Coloriees, des Maladies de l’Organe de la Vue, comprenant l’Anatomie Pathologique, la Pathologie, et la Therapeutique Medico-Chiurgicals. J. Sichel, 1859.

Tumor of the left optical orbit.

Highly vascularized tumor of the orbit originating from the inferior temporal bone, attaching to globe of eyeball, growing into lateral sinus, and applying extreme pressure to regional cartilage. Tumor and eye mass was removed successfully, relieving pain caused by growth. High blood loss from surgery, but nothing life-threatening. No vision loss in right eye.

Fig 1. Tumor in situ.

Fig 2. Tumor removed from head.

Fig 3. Cross-section of tumor.

Iconographie Ophthalmologique ou Description, avec Figures Coloriees, des Maladies de l’Organe de la Vue, comprenant l’Anatomie Pathologique, la Pathologie, et la Therapeutique Medico-Chiurgicals. J. Sichel, 1859.