DOI: 10.7925/drs1.ucdlib_280496
title: Benign osteosarcoma

description: Watercolour medical illustrations depicting benign osteosarcoma. It has the alternative reference number 1003, 17 and P10 on the front. The Richmond Hospital Museum reference is C.a.29. The entry for this in P263/1 pg. 19 reads 'Benign osteosarcoma of the fingers. Mr Adams'. There are three illustrations. The typescript note on the back reads '…look; her right hand was converted into a large globular mass, about the size of a melon, and seven inches in diameter'.
description: Scope and content: The full typescript note on the back reads '…look; her right hand was converted into a large globular mass, about the size of a melon, and seven inches in diameter; the middle and ring fingers, with their metacarpal bones, appeared to have been the principal seat of the disease: around these centres, the great bulk of the tumour had formed, so that the index and little finger were widely divaricated from each other; the last phalanges of the second finger remained unaffected by disease, and projected most conspicuously from the back part and the convexity of the morbid mass; the index, ring, and little fingers were, from the size of the tumour, rendered incapable of performing their functions, and were in a state of atrophy from want of use; there were numerous little eminences over the surface of the tumour; some of them were soft, and gave to the touch a doubtful feeling of fluctuation; the skin over some of them had ulcerated, and through the fistulous orifices which remained a thin, foetid matter exuded; at the lower part of the tumour, there existed a deep and foul ulcer, the frequent bleedings from which exhausted the patient. The disease originated in a swelling of the head of the metacarpal bone of the second finger; for three years the swelling slowly increased, and seven years elapsed before the ring finger became similarly affected, the integuments remaining, during all this period, perfectly sound. The patient stated that for nearly eight years she suffered no pain; but about the end of this period, the motions of the fingers began first to cause her uneasiness, and occasionally pain was felt at night when the hand was at rest. During the last twelve months the tumour, she thought, had doubled its former size, and the skin covering it, in different parts, became red and inflamed, and finally ulcerated. The continued ichorous and foetid discharge which took place from the large ulcer already alluded to, the inflammation and suppuration of several portions of the morbid mass, and, above all, the repeated bleedings, accounted for the exhausted condition and sallow appearance of the patient, and called for the amputation of the disease, and which Mr Cusack performed at the wrist joint on Thursday morning last. Inspection – The carpel bones were free from disease; a longitudinal section has been made of the morbid mass; the line of this section passes longitudinally through the metacarpal bone of the second finger: this bone is shorter than natural, and its lower extremity enlarged: the section shows this extremity to be excavated by a hemispherical cavity, lined by a smooth vascular membrane, and which had been occupied by an albuminous fluid: the surrounding bone was hypertrophied. Mr Adams was of opinion, that so far as this finger was concerned, the head of the metacarpal bone was the starting point of the disease. There was no bony shell to the tumour, nor osseous septa discovered, by making various sections of it. The phalanges of the fingers, projecting from the tumour presented a cartilaginous aspect, as if a soft semi-transparent, cartilaginous material had been deposited in spheroidal-shaped cells, of diameters varying from one to ten lines: the interstices, between the cysts, were occupied by a highly vascular cellular membrane: the cysts were lined by a smooth membrane, and portions of the cartilaginous material, about the size and form of a garden pea, could be turned completely out from several of their little cysts: one of these little cysts, when emptied of its albuminous fluid, was found to contain two small semi-cartilaginous bodies, attached by slender pedicles to the internal surface of the cyst *.The larger globular masses had, some of them, less the appearance of cartilage than the smaller, and presented somewhat the aspect of (* "The simplest and most elementary organic form, with which we are acquainted, is that of a cell containing another within it (nucleus) which contains a granular body (nucleolus); this appears from the interesting researches of Schleiden and Schwann, to be the primary form which organic matter takes, when it passes from the condition of a proximate principle to that of an organised substance." – See Todd and Bowman's recent and valuable Work upon Physiological Anatomy) of the bone. To prove that the latter proceeding is not always necessary, he produced to the Society a cast of the foot of a patient who had been under his care in Jervis-street Hospital, in 1833. This lad, at 18, had been sent from the country to be relieved of an osteo-sarcomatous tumour, which grew from the inner side and dorsum of the left foot:…'.
description: Numbering/sequence: Original reference number: 1003.
description: Date details: This illustration is undated, approximate dates are given based on dates for the entire collection.