Transactions of the Southern Surgical Association Volume 34 - Tapa blanda

This historic book may have numerous typos and missing text. Purchasers can download a free scanned copy of the original book (without typos) from the publisher. Not indexed. Not illustrated.1922 Excerpt: ... The word "recurrence" is employed here with the same significance given to it when applied to malignant tumors, and with full conviction that it is a misnomer in both instances. The word carries the idea of complete cessation or disappearance or removal, and in neither instance is this true. In malignancy, recurrence signifies that the tumor is not entirely destroyed or removed, and that the unharmed vestiges continue their growth until the tumor mass reappears. It is the same with recurrent prostates. No tumor or prostate can recur after all the cellular structures of their respective masses have been destroyed. This was another way of saying that recurrence of either of these pathological conditions is unmistakable proof of their incomplete removal. The word "benign" is employed to signify the clinically and microscopically benign prostate, excluding all hypertrophied prostates which show microscopic evidences of carcinoma in varying ratio, whose maximum is 14 per cent. There is too great a discrepancy between this maximum figure and the clinical course of prostates, operated and unoperated, for the surgeon to accept it as having valuable practical significance. Still, if there is microscopic evidence of malignancy, the recurrence might be accounted for on this score. Hence the establishment of benign recurrence must rest upon unquestionable cases. If these so-called malignant prostates can be cured by prostatectomy, it would not be unreasonable to admit their recurrence just as that of benign growths, or, if one prefers, as growths showing the same inoffensive type of malignancy found in the original tumor, if indeed we are to admit that benign recurrence can take place. Hypertrophy of the prostate is due to an overgrowth of connective tissue or of the g...