DOI: 10.7925/drs1.ucdlib_280055
title: Encysted tumour

description: Watercolour medical illustration depicting encysted tumour. It has the alternative reference numbers 2045 and P10 on the front. The artist's name is in the bottom right corner 'J. Connolly fec.t'. There is no Richmond Hospital Museum reference. The typed note on the back begins 'Dr Hutton exhibited a specimen of an encysted tumour'.
description: Scope and content: The handwritten note on the back has a typed note stuck over it. Therefore the full typed note reads 'Dr Hutton exhibited a specimen of an encysted tumour, which he removed three days previously from the neck of a policeman, aet thirty years. It occupied the digastric space, and extended somewhat below it, was about the size of a hen's egg, of firm consistence, and, though moveable, appeared to have as the patient expressed it "a deep root". It had one or two prominences on its surface. He felt neither pain nor soreness in the tumour, but said he wished it removed, because he felt that it was extending to the throat, there was, however, no sensible projection within the pharynx. He seemed to be in good general health, and was not aware of any of the members of his family ever having had a similar complaint. He stated that he first perceived the tumour in this situation six years ago, when it was about the size of a walnut, hard and deeply seated. For a considerable period he paid no attention to it, but when it began to increase in size he blistered it repeatedly, and applied iodine, but without benefit. The tumour slowly increased, and very gradually attained its present size. On the 6th December he was admitted to Richmond Surgical Hospital, and on the 9th the operation was performed. A crucial incision was made through the integuments over the tumour, when the platysma and fasciae of the neck were freely divided, and the cyst of the tumour was laid bare, its cellular connexion was found so exceedingly loose that the entire mass was readily turned out from the surrounding parts, simply by means of the fingers. Very little blood flowed from the superficial vessels and it was not found necessary to tie any artery. The lips of the wound were subsequently closed by a few points of suture. Upon examination of the tumour after removal it was found to have a smooth, regular cyst, upon trying to detach which from the surface of the tumour, it was found connected with septa of dense cellular membrane, which passed into the substance of the tumour, so that this was readily separated by the handle of the knife into lobules of different forms. This was a circumstance worthy of attention, as a description would be found in Liston's Surgery of a tumour taken from this situation, which presented a similar structure, and which had existed so long as twenty-five years. On examining a section of this tumour, it appeared to cate a little in consistence, being in some parts more firm than in others. There was, however, no part softened in the same way as in medullary sarcoma, nor were there portions rendered vascular and soft, as carcinomatous structure is liable to be after so long duration. When examined by the microscope some nucleated cells were observed, resembling those of epithelium rather than of malignant diseases. From the complete absence of pain in the tumour, the extreme slowness of its growth, the fact of its having so complete a cyst, and still more from the healthy appearance of the man, after the so long duration of the disease, and the unsoftened condition of the structure of the tumour, Dr Hutton was not disposed to regard the disease as malignant'.
description: Numbering/sequence: Original reference number: 2045.
description: Date details: This illustration is undated, approximate dates are given based on dates for the entire collection.