Identifier: surgeryitsprinci04keen (find matches)
Title: Surgery, its principles and practice
Year: 1906 (1900s)
Authors: Keen, William W. (William Williams), b. 1837 Da Costa, J. Chalmers (John Chalmers), 1863-1933, joint ed
Subjects: Surgery General Surgery
Publisher: Philadelphia and London : W. B. Saunders
Contributing Library: Francis A. Countway Library of Medicine
Digitizing Sponsor: Open Knowledge Commons and Harvard Medical School

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FiG. 255.—Carcinoma of the Penis. 486 SURGERY OF THE PENIS AND URETHRA. tirpation of the organ. In inoperable cases palliative measures must beresorted to. Carcinoma.—A few cases of medullary carcinoma have been re-ported, developing in young adults, usually as the result of injury.Scirrhus is one of the rarest, and epithelioma one of the commonest, formsof malignant tumors involving the organ. Among the predisposing causes may be mentioned want of cleanli-ness; chronic posthobalanitis; neglected papillomatous growths; phi-mosis, especially in men of advanced years. Not infrequently epithe-lioma has developed as the result of traumatism; it may also originate
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Fig. 256.—Inoperable Carcinoma of the Penis. Duration Six Months, Showing Unusual Malignancy. in an old cicatrix left by a chancre or a chancroid, and at the site of healedsyphilitic ulcers. It usually appears first upon the epithelial reflection of the prepuce,in a sebaceous gland, or on the dorsal aspect of the glans, about thecorona. It has a tendency to remain localized for some time before at-tacking the body of the organ. The precancerous stage, in wdiich achronic inflammatory process rebellious to treatment exists, may persistfor from a few weeks to two years before typical symptoms of malig-nancy present themselves. The growth usually develops superficially,but may arise in the deeper structures of the organ. The lesion is indo-lent, tends to persist, and does not yield to treatment. The symptoms of carcinoma vary in different cases according to the OPERATIONS UPON THE PENIS, 487 age of the patient, the nature of the exciting cause, and the existence ofcomplications. A secon

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