Melanotic Sarcoma Clitoridis.*

Abstract

Gynmologist to the J i o n t m d Gmerul Hospital ; Associate Professor of Gynmology, JlcGill, etc., etc.THE following case is of sufficient rarity to warrant its public a t' ion:Miss L. presented herself at the Montreal General ITospital on December 6 1911, being sent there by her phyfiician, Dr. J. ' l ! .Pinnie. There was nothing of interest about her sexual history, menstruation having first manifested itself when she was 14 years old, and finally disappeared a t the age of 52, with no untoward symptonis. No case of malignant disease could be discovered in her family history. When first seen, she complained of a "growth and pain in the private parts." Fire months previously, the patient had noticed sonic irritation in the vulvar region, and, later on, some blood appeared, causing her to think that her '' courses were coming on again." IIer appetite became poor, and she lost flesh. Shortly after this she noticed a growth in the vulva. This growth bled freely on the slightest irritation, but did not interfere with the functions of either the bladder or rectum. Two months ago the turuour began to be very painful at times, being less so when she was in the erect posture than when lying or sitting down. 0 1 1 examining the patient, the chest and abdomen were found t o present nothing abnormal, but the skin all over the body was loose as if the woman had lost a great deal of flesh and was of a yellowish tinge.When the external genitals were exposed, the site of the clitoris was seen t o be occupied by a tuniour which measured 8 em. f r o m before backwards and 4 em. across. This mass extended about halfway down the left labinm minus and very slightly affccted thc right. It was connected to the parts by a pedicle which scemcd to consist of the clitoris a d was freely moveable in all directions. Its surface was rough and irregular, somewhat resembling a cauliffower, and was dark and mottled and covered with blood, which was easily removed by bathing with solution. It a a s not tender to the touch but bled readily on the slightest irritation. The perineum, vagina, uterus and appendages felt healthy t o the touch.The growth was removed on December 13, the incisions on each side beginning well up in the middle of the mons veneris and being She was 62 years of age, single and uulliparous.The pain a a s worse at night.The glands in both groins were enlarged but not painful.