Excerpt from The American Gynaecological and Obstetrical Journal, Vol. 11: July-December, 1897
Another recent case called my attention still more forcibly to the difficulty of making an exact diagnosis. The patient had been under the observation of a physician in a neighboring city for nearly a year, She had had, within the last six or eight months, profuse menorrhagia, and during the last three months she had had metror rhagia more or less constantly; there was no foul discharge, and her general health was fair. She had been having for the last three months shooting pains in the back and abdomen. I examined, with a colleague, her under an anaesthetic, and found the uterus eu larged. I introduced a curette and removed a drachm of soft, brain like material. I said at the time that this was probably a case of malignant adenoma of the body of the uterus, and rather than have the woman return home unrelieved, I thought that hysterectomy was certainly indicated. Two pathologists pronounced that there was absolutely no sign of malignancy, the condition being simple adenoma. I examined some of the slides, and could myself find no evidence of malignant disease. I stated the case clearly to the patient and to her husband, and after a good deal of vacillation, they finally decided to have a radical operation. He reconsidered it several times, and when she was on the table asked whether I could swear that it was malignant, as he would not have the operation unless I could. I advised him to take his wife home at once, which he did. I have not the slightest doubt that the woman will return with well-marked malignant disease. [she did return three months later, and, on the advice of the late Dr. Lusk, I performed total extirpation success fully. The diagnosis was fully confirmed.
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