Summary.
Twenty‐four cases of tumours and cysts of the mediastinum are described, and in‐clude two cases of posterior mediastinal goitre, 1 haemangioma, and 1 lymphatic cyst.
A survey of the literature of some 600 tuniours and cysts has been made.
A brief description of the various types tumours and cysts is given.
OWING to the special functions of the hands and feet, hsmangioinata occurring in these situations present problems which do not arise in their treatment elsewhere, and the following case is of interest on this account. FICURW I. Lateral view of hand L.Y., aged twenty-four years, compIained of pain and of swelling in his left hand. He sought advice not only for these reasoils, but also because he had heen advised to refrain from working as the bones of his hand were diseased.For fifteen years he had had swelling of his left hand, chiefly of the distal part of the palm and of the index and middle fingers.His hand ached occasionally, particularly in hot weather when the swelling increased in size. Ten years ago he had received treatment with an "electric needle". Three years later he had further treatment of the same kind. Two months ago he had ultra-violet light treatment and his hand was examined by X rays. This revealed rarefaction of the phalanges, and the patient was advised to cease work lest he should sustain a fracture of the bones involved.Recently he had had pain in his hand and in the middle finger, in addition to the aching previously mentioned.On examination, on the radial and distal aspects of the palmar and dorsal surfaces of his left hand there was a soft elastic swelling which extended slightly onto the palmar and considerably onto the dorsal aspects of his index and middle fingers. As this swelling was traced onto the fingers the outline of large tortuous veins could be seen. The swelling was less towards the terminal phalanges, but through the nails of both index and middle fingers a blue colour was seen which faded on pressure. The swelling on the hand could be felt as a globular mass between the heads of the second and third metacarpals, and the knuckles of the corresponding fingers were separated by it. The skin over the palmar aspect of the mass was stippled with small white scars, evidently from the previous treatment. The swelling increased in size when the a r m was dependent and the patient complained that his fingers ached in this position. There were no abnormalities to be observed in the radial or ulnar vessels at the wrist, nor were any large vessels to be found leading to the tumour.A radiograph revealed a very distinctive picture. There was marked separation of the distal ends of the second and third metacarpals. There was slight thickening 'Accepted for publication on March 13. 1 9 4 1 . c ASIC R E 1'0U7'S.
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