The case classed as a carcinoma was secondary to cancer of the pylorus; both ovaries were affected. The three classed as tubo-ovarian were probably exceedingly large examples of hydrosalpinx; one was so big that it came in contact with the liver.
I have compared this table with the experience of other surgeons, and although there is much variation in them it represents a fair average of the proportions of the different ovarian operations usually classified under the head of ovariotomy.
Ovariotomy at the extremes of life. Cysts and tumours arise in the ovary during intra-uterine, and at all periods during extra-uterine life, even in extreme old age: they also attain such dimensions in infants and old women as to demand the aid of the surgeon, and with excellent results. Many years ago I collected the recorded cases and tabulated one hundred instances in which ovariotomy had been performed in infants and girls under fifteen years of age. These tumours fall into three groups:
| Simple cysts and adenomata | 41 | with | 3 | deaths. |
| Dermoids | 38 | " | 5 | " |
| Sarcomata | 21 | " | 7 | " |
In the case of simple cysts, adenomata, and dermoids, the results are encouraging. It is possible that some of the cases described as sarcomata belonged to the deadly group now known as malignant teratomata.
Ovarian tumours sometimes attain large dimensions in children, and Keen reported a case in which he removed an ovarian tumour from a girl which weighed 44 kilogrammes: the girl weighed 27 kilogrammes after the operation. An ovarian cyst with a twisted pedicle has been found in a fœtus at birth (Otto von Franque).
The subjoined table shows cases in which ovarian tumours have been removed from infants under three years of age. It is often stated that Professor Chiene performed ovariotomy on an infant of three months. This is an error; it was an ovary occupying the sac of an inguinal hernia.
Ovariotomy in Infants
| Reporter | Age | Result | Nature of Tumour | Reference | |
|---|---|---|---|---|---|
| 1 | D’Arcy Power | 4 months | R. | Dermoid | Trans. Path. Soc., xlix. 186. |
| 2 | MacGillivray | 11 months | R. | Cyst | Lancet, 1907, i. 1487. |
| 3 | Roemer | 1¾ years | R. | Dermoid | Deutsche Med. Woch., 1883, ix. 762. |
| 4 | Péan | 2 years | R. | Dermoid | Clin. Chir., 1887–8, 8th series. |
| 5 | Hooks | 2½ years | D. | Dermoid | Am. J. of Obst., 1886, xix. 1022. |