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Updated: May 1, 2025
Embedded bodies may remain in the tissues for an indefinite period without giving rise to inconvenience. At any time, however, they may cause trouble, either as a result of infective complications, or by inducing the formation of a mass of inflammatory tissue around them, which may simulate a gumma, a tuberculous focus, or a sarcoma.
The term sarcoma is applied to any connective-tissue tumour which exhibits malignant characters. The essential structural feature is the predominance of the cellular elements over the intercellular substance or stroma, in which respect a sarcoma resembles the connective tissue of the embryo. The typical sarcoma consists chiefly of immature or embryonic connective tissue.
Sarcoma is usually met with before the age of thirty, and is comparatively common in children. Males suffer oftener than females, in the proportion of two to one. The surface may be uniform or bossed, the consistence varies at different parts, and the swelling gradually tapers off along the shaft. On firm pressure, fine crepitation may be felt from crushing of the delicate framework of new bone.
Enlargement of the neighbouring lymph glands does not necessarily imply that they have become infected with sarcoma for the enlargement may disappear after removal of the primary growth; actual infection of the glands, however, does sometimes occur, and in them the histological structure of the parent tumour is reproduced.
From their ranks are recruited a whole army of those secessions from and rebellions against the body at large the tumors, from the treacherous and deadly sarcoma, or "soft cancer," to the harmless fatty tumor, as well as the tubercle, the gumma of syphilis, the interstitial fibrosis of Bright's disease.
Transition forms between soft fibroma and sarcoma are met with, so that in operating for their removal it is safer to take away the capsule along with the tumour, and the patient should be kept under observation in view of the risk of recurrence. The skin especially the skin of the buttock is one of the favourite seats of fibroma, and it may occur in a multiple form.
The origin of the tumour from bone may be revealed by the presence of egg-shell crackling, and by examination with the X-rays. If the condition is believed to be innocent, the treatment is the same as for aneurysm preferably by ligation of the main artery; if malignant, it is the same as for sarcoma.
On the other hand, the disease may show itself clinically as a tumour of bone, which may attain a considerable size, and may be mistaken for a sarcoma, unless the existence of the primary cancer is discovered.
The malignant neuroma is a sarcoma growing from the sheath of a nerve. It has the same characters and clinical features as the innocent variety, only it grows more rapidly, and by destroying the nerve fibres causes motor symptoms jerkings followed by paralysis.
On the other hand, the cartilage may undergo calcification or ossification. The most important transition of all is that into sarcoma, the so-called malignant chondroma or chondro-sarcoma, which is associated with rapid increase in size, and parts of the tumour may be carried off in the blood-stream and give rise to secondary growths, especially in the lungs.
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