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Un daa symboiaa suivants apparaitra sur la damiAra imaga da chaqua microficha, salon la caa: la symbols --^ signifia "A SUIVRE ', la symbols V signifia "FIN". Laa cartaa. planchas. tableaux, etc.. pauvent 4tra fiimte A daa taux da reduction diffirants. Lorsqua la document est trop grand pour dtre raproduit an un saui cliche, ii est film* d partir dm I'angia sup4riaur gauche, da gauche it droite, at da haut 9n baa. en prenant la nombre d'imagea nteassaira. Las diagrammes suivants illustrant la m^thoda. 12 3 1 2 3 4 5 6 i K: s •* ''. I ■^ :;^%,i! l:■ ^.:C!iP^"■;'rJ•.■:' . ' . .Uliig | i iii|ii i « I . III . Primary Sarcoma of the Eyelitl »v CASEY A. WOOD, M.D. CflKACO R*frittt from OpktkiUmtf Jltctndt Alurch^ iSifS lX2f Is ' S, ... Primar)' Sarcqma of the Eyeliu av CA-SEY A. WOOD, M.D. CHICAGO jR0fHnl/ri>m OpMtkatmtc Rmordy A/ttrcA, i8gS I* w I yJL r PRIMARY SARCOMA OF THE KVELID.* I5Y CASKY A. WOOD, M. 1)., OK CiriCACiO. Sarcomatous tumors of the eyelids are so exceedini,'Iy rare that 1 make no apology for presenting the following short history. Most English authors pass the subject over with but bare mention of the possibility of their occurrence, and even the transactions of the various ophthalmolog- ical societies rarely contain the history of an example. A very good account of these growths in the lid is given by (Iraefe, under the title Cylindroma (proposed by Billroth), in Vol. X, 2, p. 184, of his own Arc/iiv. In the British Medical Journal {w 1870, page 161, Samelson describes a case of sarcoma of the lid in a child ten months old. .Schirmer gives an account {Kliiiischc MoiiatshUxttcr fitr Au^tj^cf/licilkiimlf, Vol. I, p. 162) of multiple sarcomata affecting all four lids in a patient seventy years of age. Hirsch- berg also reports an example of this disease, in which there was a recur- rence shortlv after removal. Baby A., aged 7 months, an onlv chikl.was horn a healthy anil well-developed Infant, and, although nnrsed on the bottle, has al\va\ s been vigorous and to all appearances free of anv hereditary disease. There is no historv of malignant neoplasms affei-ting immediate ancestors. When she was six weeks old the mother noticed a very slight elevation on the right ui>per lid. It was firm to the touch, rolleil about untier the linger, and was not surrounded by a red or swollen area, on the skin surface, at least. It remained in .i/titii quo until the child was 3 months old. Then the mother believed it to be growing and consulted a well- known ophthalmologist, who, although he would not give a jiositive opinion as to its exact nature, ad\ ised that the jiatient be kept under obser\ation for about a motitb longer, before advising its imn.ediate removal. As the familv were about to remove to Chicago, nothing was ilone. The condition of affairs was about this, wiien I first saw her, two m()nth> ago: The right upper lid is slightlv swollen throughout and of a darker pink than the corrc'^ponding left lid. There is a roundeil prominence occupying the junction of the middle and inner third of the lid. On palpation, an irreguiarlv mal, a|)parentlv movable body, of rather tiini consistence anil of the si/e of a white bean is felt not unlike the ordinarv chalazion. 'i"he dermal \■es^el^ are slightly more numerous and larger than are those of the opposite side. On e\erting the lid the body seems to project some- what on the conjuiicti\ al aspect of the lid, ami corresponding to the jirojection is a round mass con ered with red and thickencii mucosa. The \:iscular supph is * I'reseiiliHl to tlie t.'liic,ii»ii t >plitlialinoloKical .Society. January, IMtS. decidedly greater than in the ordinary non suppurating chalazion. The mas* appears to involve the tarsus. There is apparently no pain in the eye and no increased conjunctival secretion. The tumor was completely removed, under chloroform narcosis, from the conjunctiva surface, using a fenestrated forceps. There was free hemorrhage and the tumor appeared to be imperfectly encapsulated. It involved the tarsus, part of which was removed at the time of operation Macroscopically, it resembled a piece of muscular tissue. Dr. Evans, of the Columbus Medical Laboratory, examined the growth and gives the following report: "Fresh specimen, 6x4x2 mm. No epithelial covering. Microscope shows it to be composed of round and spindle cells — more of former — with considerable intercellular substance, some pre-existing fibrous tissue, an artery with unusually thick walls. The growth is a sarcoma." The sections exhibited showed no naked vessels communicating di- rectly with the cells. So far, three months after removal, there has been no recurrence of the growth. mtrn^^ haluxion. The maifo n in the eye and no Form narcosis, from s. There was free J encapsulated. It time of operation ue. Dr. Evans, of )wth and gives the ering. Microscope -more of former — isting fibrous tissue, 1 sarcoma," communicating di- Dval, there has been IX'\ t WMKW HW .*' ' 5*i--u**aSfclis )BD Cklofs .O. iMIikM 'nnehm D. uco, f j-oo / r~