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Updated: June 1, 2025
Secondary tumours derived from the thyreoid gland require special mention, because they are peculiar in that neither the primary growth in the thyreoid nor the secondary growth in the bones is necessarily malignant. They are therefore amenable to operative treatment. Secondary sarcoma, whether derived from a primary growth in the bone or in the soft parts, is much rarer than secondary cancer.
Following the lead of Mikulicz, a considerable number of permanent cures have been obtained by resecting the portion of bone which is the seat of the tumour, and substituting for it a corresponding portion from the tibia or fibula of the other limb. In a cellular sarcoma of the humerus of a boy we resected the shaft and inserted his fibula ten years ago, and he shows no sign of recurrence.
The cut surface of the soft fibroma presents a pinkish-white, fleshy appearance, resembling the slowly growing forms of sarcoma; that of a hard fibroma presents a dry, glistening appearance, aptly compared to watered silk. The soft variety grows much more rapidly than the hard.
The treatment is conducted on the same lines as sarcoma in other situations; the insertion of a tube of radium after removal of the tumour diminishes the tendency to recurrence; a portion of the nerve-trunk being sacrificed, means must be taken to bridge the gap.
Before the stage of cold abscess is reached, the localised swelling is to be differentiated from a gumma, from chronic forms of staphylococcal osteomyelitis, from enlarged bursa or ganglion, from sub-periosteal lipoma, and from sarcoma. Most difficulty is met with in relation to periosteal sarcoma, which must be differentiated either by the X-ray appearances or by an exploratory incision.
Difficulty may arise in differentiating such a mass of bone from sarcoma; the ossification in muscle is uniformly hard, while the sarcoma varies in consistence at different parts, and the X-ray picture shows a clear outline of the bone in the vicinity of the ossification in muscle, whereas in sarcoma the involvement of the bone is shown by indentations and irregularity in its contour.
I examined her and found a frightful sarcoma of the bone, hardly showing upon the surface, but involving the shoulder-blade and clavicle as well as the humerus. A more malignant case I have never seen. I sent her out of the room and I told him the truth. What did he do? Why, he walked slowly round that room with his hands behind his back, looking with the greatest interest at the pictures.
#Cysts of Bone.# With the exception of hydatid cysts, cysts in the interior of bone are the result of the liquefaction of solid tissue; this may be that of chondroma, myeloma, or sarcoma, but more commonly of the marrow in osteomyelitis fibrosa. Definition of terms Ankylosis.
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