Fatty tumor of the neck.

Reported with remarks.

Allen, Harrison, 1841-1897.

Journal : Photographic review of medicine & surgery ; vol. 2., no. 6.

Philadelphia : J. B. Lippincott & Co., 1871-72.

Description : pp. 48-49, [1] pl. ; ill.: 1 photo. ; 24 cm.

Photograph : mounted albumen.

Subject : Neck — Lipomatous tumors.

Notes :

P., a native of Poland, aged 54 years, noticed the growth seen in the accompanying photograph some fifteen years prior to his presentation at the clinic of the Jefferson Medical College in the fall of 1863. The tumor at no time had given him any pain, nor, indeed, inconvenience beyond that necessarily arising from its great bulk and weight. It had steadily increased in size, as is the rule with this class of growths, until the patient anxiously sought for its removal. At the time of the operation it was defined as follows : A pear-shaped mass extended from immediately below the nape of the neck to a point nearly correspending to a line produced from the fold of the axilla. It arose by a narrow pedicle, at the superior aspect of which was associated a sparse growth of hair similar to that found at the nape of the neck. The anterior surface of the mass was flattened, but the posterior or upper was convex. The skin over the large end was corrugated and marked thence toward the pedicle with enlarged veins, a feature occasionally seen in old pendulous tumors. The growth, being freely movable, could be raised, and the vessels, in a great measure, emptied.

Being thus elevated, Professor Gross readily removed the mass by cutting from without inward, making two curved skin flaps with their convexities directed downward, subsequently tearing away the slight attachments which existed between the tumor and the tough connective tissue at this part of the neck. Very free hemorrhage accompanied this procedure, which, however, was soon controlled. The wound healed by first intention, and the patient was directly thereupon discharged.

The tumor proved, upon examination, to be a true fatty growth. It weighed twelve pounds.

Pendulous tumors are perhaps more frequently met with upon the regions of the back and neck than elsewhere. Rarely they arise from the temporo-maxillary region, where they may attain to a great size. Dr. Stephen Smith, in the American edition of Boyer, figures a fibroid tumor, from a female, of this description, which hung from the pedicle as far as the abdomen. In the surgical cases and observations of Dr. J. Mason Warren, a tumor, also from a female, of a "fibro-cellular" character is figured, pendent from the right arm near the axilla. This tumor was so large as to rest on the chair on which the patient sat. It weighed twenty pounds. The " Pachydermatocele" of Professor Valentine Mott, although a subcutaneous fibroid outgrowth, may be mentioned in this connection ; as well as that remarkable case, recorded by John Bell (Prin. of Surg., 1826, vol. iii. 41), of a woman, who was completely covered with enormous masses corresponding to the same description.

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Harrison Allen's most significant scientific achievements are found in zoology, particularly within his studies of the North American bat. However, he was an eminent craniologist, a successor to the legacy of Samuel Morton. His writings on fossil crania helped to establish paleo-parasitology and contributed importantly to the comparative anatomy of the nasal antrum.

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