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It was lobulated and had a large, brown-colored areola; the nipple, however, was of the same size as that on the left breast. The man stated that he first observed the breast to enlarge at sixteen and a half years; since that time it had steadily increased, but there was no milk at any time from the nipple; the external genital organs were well and fully developed.
Wens are to be diagnosed from dermoids, from fatty tumours, and from cold abscesses. Dermoids usually appear before adult life, and as they nearly always lie beneath the fascia, the skin is movable over them. A fatty tumour is movable, and is often lobulated.
One species becomes as large as the crown of a man's hat; it is pure white, with a blush of brown in the middle of the crown, and is very good roasted; it is named "Motenta;" another, Mofeta; 3rd, Boséfwé; 4th, Nakabausa; 5th, Chisimbé, lobulated, green outside, and pink and fleshy inside; as a relish to others: some experience must have been requisite to enable them to distinguish the good from the noxious, of which they reject ten sorts.
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 from elephantiasis. Circumscribed lipoma appears as a lobulated soft tumor, more or less movable, lying beneath the skin.
The present dimensions of the tumor, which for fifteen years had been accompanied with pain, and had progressively increased in size, are as follows: Circumference at the base, 19 1/2 inches; circumference at the extremity, 11 1/4 inches; distance of extremity from abdominal wall, 12 3/4 inches. Inspection showed a large lobulated tumor protruding from the abdominal wall at the umbilicus.
It forms a rounded, lobulated swelling, seldom of large size and yielding a sensation like that of a sponge; the skin over it is normal, or may exhibit a bluish tinge, especially in cold weather. In some cases the tumour is diminished by pressing the blood out of it, but slowly fills again when the pressure is relaxed, and it swells up when the child struggles or cries.
It also affects parts covered by mucous membrane, such as the cheek, tongue, and soft palate. The swelling is rounded or lobulated, and projects beyond the level of its surroundings. Sometimes the skin is invaded by the nævoid tissue over the whole extent of the tumour, sometimes only over a limited area.
The cloister, bare on the inner side, is nevertheless a modest Gothic structure with acceptable lobulated ogival windows. Western Castile The history of Palencia can be divided into two distinct parts, separated from each other by a lapse of about five hundred years, during which the city was entirely blotted out from the map of Spain.
The swollen limb presents immense lobulated masses, heaped up at different parts, separated from one another by deep sulci, which are especially marked at the flexures of the joints.
The leg below the knee has become enormously deformed by the production of the elephantoid masses; the outer side of the thigh remains healthy, but the skin of the inner side has developed so as to form a very large and pendant lobulated mass. A similar condition has begun to develop in the other leg, which is row about in the condition of the first, as shown in the figure.
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