Gynécologie . les intestins ne sont pas présents à moins que la tumeur soit compliquée par un processus inflammatoire, tel que peut s'ensuivre de salpingite ou de torsion du pédicelle. Dans la mesure où la maladie est habituellement confinée à un côté, et il y a peu de tendance à la récidive ultérieure dans l'ovaire non affecté, une simpleextirpation de la tumeur, sans l'enlèvement des autres organes du bassin, isall qui est nécessaire. Il faut toutefois se rappeler que LA dégénérescence carcinomateuse DES NOUVEAUX CULTIVATEURS 333, bien que rare, est encore possible, et la règle de faire un examen insouciant du gro

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Gynecology . sions to the intestines are not present unless the tumor is complicated by someinflammatory process, such as might ensue from salpingitis or from torsion ofthe pedicle. Inasmuch as the disease is usually confined to one side, and asthere is little tendency to later recurrence in the unaffected ovary, a simpleextirpation of the tumor, without removal of the other organs of the pelvis, isall that is necessary. It should be remembered, however, that carcinomatous NEW GROWTHS 333 degeneration, though rare, is still possible, and the rule of making a carefulgross examination of the growth before closing the abdomen should always becarried out, as in the removal of all ovarian neoplasms. If carcinoma is discov-ered, the uterus and other ovary should be removed. According to Pfannenstiel, carcinomatous recurrences have taken place in the scar of the stump from whichthe tumor has been removed. This complication, however, must be so rare thatit need not be taken into very serious consideration.. Fig. 132.—Papillary Cystadenoma of the Ovary.Low power. The papillary projections from the wall of the cyst can be seen cut in variousplanes. They consist of a connective-tissue stroma containing blood-vessels, covered with a singlelayer of cylindric epithelium. The spilling of the cyst contents in the abdominal cavity is attended withless risk than in the case of serous cystadenomata, as the epithelial elementshave less tendency to implant themselves on the peritoneum. This, however, is not universally true, for it occasionally happens that cell elements that haveescaped from the cyst into the peritoneal cavity, either spontaneously or fromaccidental rupture during operation, form implantation metastases, which, bythe peristaltic movements of the intestine, may become disseminated through-out the abdomen. The cells continue to secrete pseudomucin, so that as a 334 GYNECOLOGY result the entire peritoneal cavity becomes filled with extensive gelatinousmasses that cannot e

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