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Updated: May 1, 2025
Good results are also reported from the application of carbon dioxide snow, especially when this follows upon a course of X-ray treatment. #Melanotic Cancer.# Under this head are included all new growths which contain an excess of melanin pigment. Many of these were formerly described as melanotic sarcoma. They nearly always originate in a pigmented mole which has been subjected to irritation.
A rarer variety is the ossifying chondro-sarcoma, which undergoes ossification to such an extent as to be visible in skiagrams. In primary sarcoma the treatment consists in removing the muscle. In the limbs, the function of the muscle that is removed may be retained by transplanting an adjacent muscle in its place. Hydatid cysts of muscle resemble those developing in other tissues.
Although formerly classified as a sarcoma, it is the exception for it to present malignant features, and it can usually be extirpated by local measures without fear of recurrence. The diagnosis, X-ray appearances, and the method of removal are considered with the diseases of bone. #Myoma.# A myoma is composed of non-striped muscle fibres.
These varieties, although met with chiefly in the bones, may occur in soft tissues such as muscle, and in such organs as the mamma. The pigmented varieties include the chloroma, which is of a light-green colour, and the melanotic sarcoma, which is brown or black. The psammoma is a sarcoma containing a material resembling sand; it is chiefly met with in the membranes of the brain.
Fourth. Even if the rays can be made to permeate the thicker parts of the body, it is doubtful whether tumors, such as cancers, sarcoma, fatty tumors, etc., which are as permeable to the rays as the normal soft parts, can be diagnosticated. Bony tumors, however, can be readily diagnosticated; and possibly fibrous tumors, by reason of their density, may cast shadows. Fifth.
When resection is impracticable, a subcapsular enucleation is performed, followed by the insertion of radium. #Pulsating Hæmatoma# or #Aneurysm of Bone#. A limited number of these are innocent cavernous tumours dating from a congenital angioma. The majority would appear to be the result of changes in a sarcoma, endothelioma, or myeloma.
The tumour tissue, when exposed by dissection, is of a chocolate or chamois-yellow colour, and consists almost entirely of giant cells. The treatment consists in dissecting the tumour tissue off the tendons, and this is usually successful in bringing about a permanent cure. All varieties of sarcoma are met with, but their origin from tendon sheaths is not associated with special features.
It would appear that most of the recorded cases of cysts of bone owe their origin to this disease, while the abundance of giant cells with occasional islands of cartilage in the wall of such cysts is responsible for the view formerly held that they owed their origin to the liquefaction of a solid tumour, such as a myeloma, a chondroma, or even a sarcoma.
Other forms of sarcoma, and the enlargement of an accessory thyreoid, are less likely to be confused with tuberculous glands. Calcified tuberculous glands give definite shadows with the X-rays.
When attended with suppuration, the condition has been mistaken for disease of the jaw. Fibrous odontomas have been mistaken for sarcoma, and portions of the maxilla removed unnecessarily. Any circumscribed tumour of the jaw, particularly when met with in a young adult, should suggest the possibility of an odontoma. Skiagrams often give useful information both for diagnosis and for treatment.
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