SYPHILIS AND CANCER. ETCHEVERRY. (_Ann. de Derm. et de Syph._,
August-September, 1904, p. 797.)
This research was undertaken in Audry’s Clinique at Toulouse, and the
consideration of the connection between these two diseases was directed
to the occurrence of lesions on the tongue and buccal mucous membrane.
These facts are grouped in three classes, according as: (1) cancer
supervened, in syphilitic patients, upon a preceding leucoplakia; (2)
without leucoplakia, but in the presence of other local syphilitic
lesions, such as gummata, scars of gummata, or of hard chancres; and (3)
in the absence of all local signs of syphilis. Thirteen cases of
epithelioma developing upon syphilitic leucoplakia are detailed under
the first heading. This sequel is relatively frequent. In the second
group twenty-two cases are noted. In the third group no direct
transformation of syphilitic into epitheliomatous lesions could be
established, but the fact of previous syphilis was ascertained in all
the fifteen cases quoted. Etcheverry, struck with the singular frequency
of association of the two diseases, speculates whether there may not be
some direct predisposition in syphilitic patients, as such, to develop
cancer. In epithelioma of relatively young patients he states that
syphilis may almost always be found as a previous accident. The greater
frequency of cancer of the mouth in men than in women coincides with the
greater frequency of syphilis in men; according to Fournier, syphilis is
eight times more common in males. Etcheverry hazards the suggestion that
the cachexia produced by syphilis may be a directly provocative cause of
ensuing cancer. As regards the treatment of these mixed cases of
syphilis and cancer, the administration of mercury, preferably by
injections of calomel, influences favourably the syphilitic element of
the disease, and occasionally, as a temporary effort, the
epitheliomatous development is checked by this drug. On the other hand,
iodides are distinctly mischievous to the malignant growth, and should
not be given.
It is probable that the same close connections obtain between cancer and
syphilis of the rectum as has been here noted in the case of the mouth,
but observations on this point are too few to be of value.
A very full bibliography is added to this careful paper.