Treatment.—In early cases the cortex is opened up to give free access to the tumour tissue, which is scraped out with the spoon. Bloodgood advises the use of Esmarch's tourniquet, and that the curetting be followed by painting with pure carbolic acid and then rinsing with alcohol; a rod of bone is inserted to fill the gap. In advanced cases the segment of bone is resected and a portion of the tibia or fibula from the other limb inserted into the gap; a tube of radium should also be introduced.
Fig. 146.—Periosteal Sarcoma of Femur in a young subject.
The coexistence of diffuse myelomatosis of the skeleton and albumosuria (Bence-Jones) is referred to on [p. 474]. Myeloma occurs in the jaws, taking origin in the marrow or from the periosteum of the alveolar process, and is described elsewhere.
Sarcoma and endothelioma are the commonest tumours of bone, and present wide variations in structure and in clinical features. Structurally, two main groups may be differentiated: (1) the soft, rapidly growing cellular tumours, and (2) those containing fully formed fibrous tissue, cartilage, or bone.
Fig. 147.—Periosteal Sarcoma of Humerus, after maceration.
(Anatomical Museum, University of Edinburgh.)