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Updated: June 27, 2025
An oval swelling forms in the upper part of the thigh, is soft and prominent when the muscle is relaxed, less prominent when it is passively extended, and disappears when the muscle is thrown into contraction. It is liable to be mistaken, according to its situation, for a tumour, a cyst, a pouched vein, or a femoral or obturator hernia.
But for four years he had waited for chance to draw him a good ticket in the lottery of life a rich patient afflicted with a cyst or a tumor that he would take to a fashionable surgeon, who would divide with him the ten or fifteen thousand francs that he would receive for the operation. In that case he would be saved. He ran to the door.
The differential diagnosis is to be made from abscess, bursal cyst, enlarged glands, and sarcoma, especially pulsating sarcoma of one of the bones entering into the knee joint. The choice of operation lies between ligation of the femoral artery in Hunter's canal, and Matas' operation of aneurysmo-arteriorrhaphy.
The apex of the heart was pushed to the 3d interspace and the umbilicus had disappeared. There were 65 quarts of a thick, brown fluid in the tumor. The patient recovered in twenty-five days. Cullingworth of St. Thomas Hospital, London, successfully removed from a girl of sixteen an ovarian cyst weighing over 80 pounds. The patient was admitted to the hospital April 30, 1895.
Exudation cysts arise from the distension of cavities which are not provided with excretory ducts, such as those in the thyreoid. Implantation cysts are caused by the accidental transference of portions of the epidermis into the underlying connective tissue, as may occur in wounds by needles, awls, forks, or thorns. The implanted epidermis proliferates and forms a small cyst.
The cyst varies in size from a pea to a pigeon's egg, and usually attains its maximum size within a few months and then remains stationary. It becomes tense and prominent when the hand is flexed towards the palm. Its appearance is usually ascribed to some strain of the wrist for example, in girls learning gymnastics.
It is quite possible for a fibrocyst of the uterus to attain an enormous size, equaling the ovarian cysts. Stockard describes an instance of this nature in a negress of fifty, the mother of several children. About twelve years before a cyst in the right iliac region was tapped.
The walls of the cyst were sewn to the margins of the abdominal wound, the edge of the placenta being included in the suture. A wound was thus formed 10 cm. in diameter, with the placenta for its base; it was filled with iodoform and salicylic gauze. The operation lasted an hour, and the child, a boy weighing 5 1/2 pounds, after a brief period of respiratory difficulties, was perfectly vigorous.
The cyst is usually situated between the skin and fascia, and contains clear or blood-stained serum. At first it is lax and fluctuates readily, later it becomes larger and more tense. The treatment consists in drawing off the contents through a hollow needle and applying firm pressure.
When the pyogenic cyst is once broken the pus becomes diffused, and as it has no retaining membrane it burrows in all directions, and more or less of it is absorbed, causing pyomia.
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