Rose, Lewis W.

English

ZENODO

FIBROLIPOMA OF JAW AND NECK. BY LEWIS W. ROSE, M.D., OF ROCHESTER, N. Y. Henry C. D., age 6G, was brought to my service in the Rochester City Hospital by the ambulance, September 15, 1905. He had fallen unconscious in the street, and received a scalp wound over the right frontal region. His fall was probably due to a slight cerebral hemorrhage, from which lie recovered, as he did from one two years ago. This man is well known in Rochester, and is a familiar char¬ acter on the streets. He is especially conspicuous by reason of an enormous mass on the left side of his neck, which lie has always kept covered with a black silk bag. "1 he patient stales that this large, tabulated and pedunculated tumor (Fig. 1) has been gradually and continuously growing for about forty-three years. He also states that it started below the angle of the lower jaw, and was not connected with the parotid gland. It now measures, in its largest circumference, 25 inches; around the pedicle it is 17 inches, and in length, from base to apex, about 16 inches. The skin is slightly movable over the growth in most places. It has some areas more or less adherent, due in part, probably, to the inflammatory action caused by the punctures of a needle which was used some years ago in treating the tumor by electrolysis. In color and texture the skin resembles that of his face; the beard extends out over the growth, and hair thinly grows over most of it. The superficial veins are very large and prominent. The skin becomes stretched, tense and shiny when the tumor is not supported. This appearance is caused not only by the great weight, but also by the momentary rapid increase in size, due to the engorgement of blood within the tumor. On palpation a tabulated, pedunculated mass is felt. It is movable about the structures of the neck at the point of attach¬ ment. Some of the tabes are quite hard, others impart a sense of elasticity, and one area is soft and apparently fluctuates. Por¬ tions of the skin arc much thickened. Manipulation at times causes pain. 500 PIBROLIPOMA OF JAW AND NECK. SOI Some of the older writers, Muller, Rokitansky, Glugc and other German histologists, have given us the term “ Mixed Lipoma," which term l think can he used to describe this growth. Fibromata of the neck arc described as being connected with the ligamenlum nucha: or vertebral periosteum; they vary in consistency, and may he either clastic or of stony hardness. Some of the large tumors originating from the parotid gland arc also described as fibroid; chondromata also have their origin from this gland. In my ease the tumor docs vary in consistency, however, it did not originate from the structures mentioned. It was originally probably a simple lipoma. That it is now a mixed lipoma may be inferred—First, from the presence of hard lobes, which hardness is due to an increase of the connective tissue stroma with fat oblitera¬ tion—fibrolipoma. Second, from the presence of soft, jelly- like, and apparently lluctuating lobes—myxolipoma; this myxomatous degeneration is, according to Senn, the most fre¬ quent retrogressive metamorphosis in the stroma of these organs. Thirdly, from the apparent increase in size when this tumor hangs unsupported and the decrease in size when it is supported and slightly compressed, it is inferred that lipoma telangiectasis and also lipoma cavernosa exist. There is no apparent calcification and it probably is not present. This form of degeneration, occasionally occurring in these tumors, arrests their growth. There never has been any arrest of development in this ease. It has been a slow, con¬ tinuous, and painless process. The patient states that about forty years ago, when the tumor was small, a New York surgeon advised against its removal, as the result would probably be fatal. Since then he has not entertained the idea of surgical interference. Never until this time would he consent to be photographed, or have the ease reported. 33 

Fibrolipoma of Jaw and Neck:

https://zenodo.org/record/1798714/files/article.pdf

Fibrolipoma of Jaw and Neck:

Abstract

Similar works

Full text

Available Versions

ZENODO