Circumscribed lipoma of back. (Dennis.)
Fig. 508
Congenital diffuse lipoma of back. (Mixter.)
They are sometimes multiple and perfectly innocent, save as they may attain large size or ulcerate from surface irritation. The granulomas, especially those of syphilis and tuberculosis, are common, appearing either as superficial tumors which ulcerate, or as deeper ones which may break down in the course of months or years, after perhaps involving the ribs or a considerable portion of the chest wall. Actinomycosis is perhaps as often seen in this region of the body as anywhere.
The fibromas are seen more commonly in the axilla and beneath the thoracic musculature. The chest is a frequent site for those pedunculated fibromas which have been described under the term keloid. A most striking case of neurofibroma of the skin is portrayed in [Plate XLIX].
Chondromas of the chest are slow-growing, usually painless, may involve a considerable area, both of bone and cartilage, are not infrequently the seat of cystic changes, and often undergo a final sarcomatous degeneration. All this is true in lesser degree of the osteomas, which are of the cancellous type.
The malignant tumors of the thorax proper are mostly sarcomas which assume various types, according to their cellular characters, the round-cell sarcomas growing rapidly, becoming extremely hemorrhagic and fungous, and tending to kill early, while the larger and more spindle-cell and the giant-cell forms grow relatively more slowly, and may even be successfully removed ([Figs. 509] and [510].)
Fig. 509
