1 Retention cysts.
2 Proliferation cysts.
II.--_Cysts which are of congenital origin and are true tumors._
1 Dermoid cysts.
III.--_Cysts which originate independently as the result of pathological
changes and are nontumorous._
1. Cysts formed by the softening and disintegration of
lesions Softening cysts.
2. Cysts formed around parasites Parasitic cysts.
3. Cysts formed by an outpouring of blood and lymph
into the tissue spaces with subsequent
encapsulation of the fluid Extravasation cysts.
TERMINOLOGY.--The principle of naming tumors is quite simple. The Greek
word "oma" (plural "omata") means tumor. This word "oma" is added to the
stem of the word ordinarily used to designate the kind of tissue of which
the tumor is composed. Thus a tumor formed after the type of fibrous tissue
is a fibroma. The only exception to this is in the naming of the two large
classes of malignant neoplasms. There the names were formed from the
fleshlike appearance of the one and the crablike proliferations of the
other--namely, Sarcoma (sarks=flesh), carcinoma (karkinos=crab).
DIAGNOSIS.--In the diagnosis of tumors note is taken of (1) clinical
history and (2) examination of the tumor.
(1) _Clinical history._--Circumstances connected with the origin of the
tumor and its rapidity of growth may point to an inflammatory swelling
rather than a tumor. The location of the tumor at its commencement is
important, as, for instance, in diagnosing between lipoma and carcinoma,
the former being more or less movable under the skin, while a carcinoma
develops in the skin. While tenderness on pressure may be caused by
compression of a sensitive nerve by a tumor or by tumors of the nerve or
nerve sheaths, as a rule this symptom is indicative of inflammatory
swelling rather than of the existence of a tumor.
(2) _Direct examination of the tumor._--In the application of this
diagnosis the trained observer will note color, size, shape, and surface
structure, transmission of light, movableness, consistence, resistance,
pulsation, and crepitation. Percussion, auscultation, and exploration are
also available methods. Finally, microscopic examination of the growing
portions of the tumor by a pathologist will be found most satisfactory.
GENERAL TREATMENT OF TUMORS.
For benign tumors treatment is required only when it damages the animal's
value or when merely for sake of appearance. When it is possible, the
removal of the tumor by an operation is indicated. If the tumor has a
small, constricted base, remove by torsion, ligation, or with an Ècraseur.
Ligation following the incision of the skin with a knife avoids the pain of
pressing on the sensitive nerves of the skin and is suitable for tumors of
broad base and small bodies. A firing iron, such as is used in line or
feather firing, may also be used in removing tumors with small attachments.
This not only stops the bleeding but forms a firm scab, under which healing
may occur rapidly. Those tumors that can not be removed by the above
methods may be treated with caustics or acids, such as sulphuric acid,
hydrochloric acid, caustic potash, arsenic, silver nitrate, or chromic
acid, but it is difficult to limit the action of these drugs. The
injection, into the tumor, of such chemicals as anilin dyes, alcohol,
acetic acid, citric acid, or ergotin, is of doubtful value, as is also the
injection of the germs of erysipelas--thought by some to be a specific.
Certain specific tumors, such as actinomycosis and botryomycosis, may be
successfully treated by the internal administration of potassium iodid,
together with the injection into the tumor or the painting of its surface
with either Lugol's solution or the tincture of iodin. The most reliable
means of treating tumors is by extirpation with cutting instruments.
Dissect the tumor from the surrounding tissue, ligating all the larger
blood vessels, and tearing the tissues with the fingers rather than cutting
with a knife. The bleeding may be stopped with a hot iron. The after
treatment is the same as for any ordinary wound of similar size.
DESCRIPTION OF INDIVIDUAL TUMORS.
Although a full list of the tumors that may be found in bovines has been
given above, there are a number that warrant a detailed description, and
the following mention will be made of the most important of them:
MYOMA.
These tumors are after the type of muscle. They are sharply circumscribed
and, as a rule, are very hard, a condition owing usually to combination
with fibroma and are then known as fibromyoma. In fact, the clinical
differentiation between myoma and fibroma is almost impossible. Myomas are
found in the uterus, vagina, stomach, intestines, gullet, and bladder of a
bovine animal. They grow very large, but, as a rule, are benign. Treatment
should consist of their removal.
NEUROFIBROMA.
A true neuroma built up of nerve fibers and nerve cells is infrequent, if
it ever occurs, in cattle. False neuromas, or neurofibromas, are knotty,
spreading tumors of the size of a large potato, which are developed within
the nerve sheaths and composed of nerve fibers and connective tissue bands
interlaced. The commingling of these varied fibers is often so intricate
that separation is practically impossible. This tumor is most frequently
found upon the shoulder of cattle. Treatment is surgical.
ANGIOMA.
The angiomas are tumors composed mainly of blood vessels or blood spaces
and are observed on the skin of man, where they are called "birthmarks" or
"mother marks." Cavernous angiomas are seen in cattle, affecting the liver
and the mucous membrane of the nasal septum. In the liver they appear as
smooth, flat, nonprojecting tumors of a dark-red or purple color and of
about the size of a silver 10-cent piece. They are somewhat softer in
consistency than the adjoining liver substance into which they are
gradually fused. These tumors are frequently observed by meat inspectors in
livers of slaughtered cattle. Treatment of angioma is unnecessary.
ADENOMA.
The structure of this tumor is after the type of gland tissue. It is rarely
seen in cattle except in combination with cancer or sarcoma. A growth which
occurs more frequently in bovines, especially calves, and which in some
instances bears a striking resemblance to an adenoma is the so-called
goiter.
GOITER (STRUMA).
This is a noninflammatory enlargement or a hyperplasia of the thyroid
gland. While it can not be definitely classed among tumors, yet, owing to
its resemblance to the latter, it will be discussed at this time. The cause
of goiter has never been definitely ascertained. Among the most probable
causes may be mentioned heredity, insufficient and improper diet, close
confinement, unhygienic surroundings, and an unknown toxic substance which
is supposed to obtain in those localities rich in magnesium and lime salts.
Certain organisms found in goiter have been suspected of producing this
trouble, but their relation to the disease has not been satisfactorily
proved. A goiter may consist of (1) simple enlargement of the follicles
which are filled with albuminous matter (follicular goiter); (2) an
increase of connective tissues between the follicles, causing the swelling
to be dense and resistant (fibrous goiter); (3) a great increase in size of
one or more follicles, forming a cyst (cystic goiter); (4) great dilatation
of the blood vessels in the gland accompanied with pulsation with each
heart beat (vascular goiter).
_Symptoms._--Goiter may be observed at the side of the throat, reaching the
size of a fist or even larger, or it may hang down below the windpipe. In
cattle the two thyroid glands are close together, and when the disease
affects both there may be but one uniform swelling placed in front of the
windpipe below the angle of the jaw. This swelling may be hard, soft, or
doughy in consistence, and with each beat of the heart it may pulsate like
an artery. It may cause labored breathing by pressure on the windpipe, and
death may result from pressure on this structure, on the gullet, or on the
adjoining large vessels.
_Treatment._--In young animals the treatment is usually satisfactory, and
consists in giving the animal a complete change of feed and plenty of
exercise in the open air. If the condition appears enzootic in the
district, remove the animal to another location when possible. Iodin,
either in the form of ointment or the tincture, should be applied to the
swelling. Injections of iodin solution, 5 grains of iodin in 1 dram of 25
per cent alcohol, may also be made into the substance of the gland. When
the swelling which follows this injection has subsided it may be repeated.
Potassium iodid should be given internally in 1-1/2 dram doses twice daily
for a cow, or in 20-grain doses twice a day for a calf. Extirpation of all
but a small section of the swelling may be successfully accomplished by a
qualified veterinarian, but if it should be entirely removed, myxedema and
death follow.
FIBROMA.
Fibromas are tumors made up chiefly of connective tissue and are usually
confined to the skin and subcutaneous tissue. Indurative fibromas of the
skin appear as tumors of gelatinous connective tissue or as firm, white
vascular connective tissue growths, which are more or less sharply
outlined, move readily over the underlying tissues in company with the
skin, and owe their origin to mechanical injuries, perforating wounds,
repeated abrasions, or the invasion of pus cocci or botryomyces into the
tissues.
These tumors in cattle are frequently found upon the dewlap as solid lumps,
hard as stone to the touch, lying loosely between the layers of skin, and
gradually losing themselves in the softer tissues of the neck above, or as
smooth, hard tumors of glistening white substance with interlacing lines of
softer tissue. They may also be found in the region of the knee or at the
elbow. The skin over the growths, in accordance with the originating cause,
will be found chafed, covered with scabs, or even ulcerated and accompanied
with collateral edema.
These connective tissue tumors grow slowly but reach enormous size. They
sometimes follow injuries to the region of the throat and form there as
hard, firm growth, even reaching the size of a child's head.
A fibroma upon the larynx is not an infrequent occurrence in the ox. These
tumors are always sharply outlined and have a roughened surface. They may
be differentiated from actinomycotic tumors (see chapter on "Infectious
diseases of cattle," p. 358) in the same location by their firm, fibrous
structure and by the absence of pus from the interior.
A tumor is sometimes seen upon the muzzle of cattle, which assumes a
diameter equaling the width of the muzzle. It is a voluminous
connective-tissue formation known by the name of "fibroma diffusum."
Another form is sometimes observed upon the tongue. It grows upon a broad,
spreading base, becoming very hard. It is almost lacking in blood vessels,
although the few that are present are plainly in view, and in consequence
is poorly supplied with fluids. It is of a smooth contour, white or whitish
yellow in color, is sharply limited from the normal substance of the
tongue, may be covered with mucous membrane, on which prominent papillÊ are
located, or only by a thin, delicate layer of epithelium, and is usually
found in the middle part of the tongue, where it may reach the size of two
fists.
Pedunculate or stemmed fibrous tumors are frequently noticed growing upon
or near the extremity of the tails of cows. They are apparently of
traumatic origin, such as tying the tail fast while milking or shaving it
too closely while trimming for show purposes, and usually contain bloody or
gelatinous material within, or, again, they may be strongly edematous
throughout.
_Treatment._--The treatment of large fibromas is surgical and consists of
the operative removal of the tumor, followed by suturing of the wound.
Small external tumors may be painted with zinc chlorid, chromic acid, or a
concentrated solution of bichlorid of mercury.
PAPILLOMA (WART).
When fibromas develop from the lining or covering tissues they frequently
form papillary growths, more or less thickly covered with epithelium, and
are then called papillomas, or warts.
Papillomas consist of villouslike projections, resulting from a
proliferation of the outer layer (epithelium) of the skin or mucous
membrane. These growths are also called "angle berries," and may assume a
variety of forms. Sometimes there is a preponderance of epidermis in the
formation, and the tumor then appears as a hard, dense, insensitive,
clublike growth, or wart. Again the swelling is chiefly in the derm, or
true skin, and we have what is known as a flesh wart (verucca carnea). In
other cases the growth of papillar bodies projects in great cauliflowerlike
tumors with deeply furrowed and lobulated surface, over which a covering of
epidermis may or may not be present. These are usually much softer and are
well supplied with blood vessels. It is not uncommon for them to be
pedunculate or stemmed, and in this case considerable rotary motion or
twisting is possible. Their color is cloudy gray or grayish red, with white
bands of connective tissue radiating from the center. Their consistence
varies. Upon their surfaces and within their clefts and fissures they
undergo retrogressive changes, softening, bleeding, or ulcerations.
A favorite location for the papilloma in cattle is the udder and teats,
where they may develop in such numbers as to cover the entire surface and
make the animal troublesome to milk. The sides of the head, neck, and
shoulders also afford satisfactory conditions for their growth, and are
frequently seen to be affected by them.
_Treatment._--Warts may be removed with the scissors, twisted off with the
fingers, or ligatured by means of a rubber band or horsehair. The roots
should then be cauterized with tincture of iron, glacial acetic acid, or
lunar caustic. Acids should never be used in removing warts about the eyes
or in the mouth. Papillomas of the eyelids sometimes change to cancers and
should be removed by taking out a wedge-shaped section of the eyelid. Young
cattle should be given arsenic internally in the form of Fowler's solution,
1 tablespoonful twice a day for a 6-months-old calf.
POLYPS.
Polyps are usually fibromas or myxomas, occurring on the mucous membrane of
the nasal passages or genital tract. They grow upon a narrow stem, bleed
readily when injured, and often contain a center of thin, limpid fluid. A
bloody discharge is sometimes seen coming from the affected nostril, but
this is not always easy of detection in cattle, owing to the pliancy of
their tongues and to their habit of licking an irritated nostril. Usually
these tumors grow downward and may project from the nostril, causing
snoring sounds and uneasy breathing. They may occasionally force themselves
backward into the throat, where they interfere seriously with respiration,
the patient being obliged to breathe with an effort, and even forced to
cough in order to dislodge temporarily the obstruction from the larynx.
Such tumors, when near the nostril, may easily be removed by the use of
forceps or a loop made of bailing wire. Serious bleeding is not liable to
follow their removal, but an astringent wash, such as a solution of the
perchlorid of iron, if applied to the cut surface, will be found very
beneficial. In case the tumor is not within easy reach, the services of a
qualified veterinarian should be obtained to perform the necessary
operation.
LIPOMA.
This is a tumor consisting chiefly of fat cells. The growth is irregularly
rounded and distinctly lobulated, very soft, and almost fluctuating. It is
insensitive, grows slowly, and is always inclosed in a distinct fibrous
capsule, from which it can be easily shelled out. It may become very large
and often hangs pendulous from a long, elastic pedicle. In cattle this
tumor may be found in the subcutaneous tissues, especially of the back and
shoulders, uterus, and intestines, and in the latter position it may cause
strangulation, or "gut tie," by winding around a loop of the intestine.
_Treatment._--When found on the skin the tumor may be readily removed with
a knife or by a ligature. Caustics and the cautery produce wounds that heal
slowly and can not be recommended in the treatment of this tumor.
CHONDROMA.
This tumor formation is composed of cartilage cells. It is a rounded and
very often unevenly nodular and sharply described tumor. It is very hard,
dense, elastic, and painless and develops principally where we find normal
cartilage cells. It is rare in cattle, but has been found in the
subcutaneous tissues and nasal cavities.
_Treatment._--Extirpation.
OSTEOMA (BONY TUMOR).
Bones may occasionally grow in such a profuse and irregular manner that the
product, or osteophyte, assumes the character of a tumor. The bone tissue
may possess either spongy or compact properties and grow either from the
periphery of the bone or within its interior. These tumors most frequently
appear about the head of the animal, either upon the jawbones, within the
nasal passages, or in connection with the horns. They are usually of bony
hardness, painless, benign, and sharply outlined.
_Treatment._--The treatment consists in either removing them with a saw,
chisel, or trephine, or preventing their further development by
counterirritation with blisters or firing iron.
MYXOMA.
Characteristic myxomas are mucoid tumors which chiefly originate from the
mucous membrane and are especially to be found within the nasal passages
and uteri of cattle. They can reach a size of three fists, are smooth or
velvetlike, or may be lobulated, broad at the base, and consist of a
glassy-looking mass of connective tissue, which usually shows a distinctive
yellowish color. Being homogeneous and elastic, the moist, jellylike tissue
composing the tumor may be easily destroyed or crushed. When cut through,
these tumors soon collapse from the loss of their fluids. They sometimes
inclose elliptical cavities filled with slimy, gelatinous masses.
_Treatment._--Extirpation.
SARCOMA.
This is a malignant tumor after the type of embryonal tissue, and consists
of several varieties, such as the round cell, spindle cell, giant cell,
alveolar, and melanosarcoma. They grow by preference in connective tissue
and are quite vascular. Sarcomas appear either as single or multiple
nodules, varying in size from a hempseed to a hazelnut, or else as a
moderate number of tumors of the size of hen eggs. Their surface, at first
smooth, later becomes lumpy and tuberous from internal degeneration.
Secondary nodules may appear near the primary tumor. The outer skin is not
involved so soon as in cancer, nor does ulceration follow so rapidly.
Sarcoma is about the most frequent and dangerous tumor that is found in
cattle. It occurs in young animals, and is found on the serous membranes,
in the glandular organs, and on the outer skin, especially of the neck and
shoulders--in fact, in nearly every tissue and in almost every part of the
body. This tumor is often found in places exposed to traumatisms and at
seats of scars, or of irritations from pressure and inflammation.
_Treatment._--Treatment should consist in early and complete removal by the
knife, including one-half or three-quarters of an inch of the sound tissue
adjoining the tumor. If there is a possibility that sarcomatous tissue
still remains, either cauterize the wound with a hot iron or powder the
walls of the cavity with arsenious acid.
CANCER (CARCINOMA).
Cancers are tumors of epithelial tissues and are malignant. There are
several varieties of cancers, such as hard, soft, and colloid, but only
those growing on the surface will be mentioned here. These malignant tumors
of the superficial organs develop primarily from the epidermis or from the
glands of the skin. They appear secondarily as spreading infections from
milk glands, thyroids, anal glands, or as embolisms. In such cases their
sole character depends wholly upon the kind of cancer from which they have
sprung. The infiltrating cancer begins as an elevation of the skin, which
progresses until it becomes rough and nodular. The surface later becomes
attacked, and an ulcer results whose edges are outlined by a hard, firm
zone.
The ulcerations may remain limited by cicatricial tissue, but it is more
likely that the infiltration and destruction of tissue will spread out
wider and deeper until a rodent ulcer (so called) is formed. One of the
most frequent sites of cancer in cattle is in the eye, where they are
called fungus hematodes, but they also occur on the skin, on the genitals,
in the stomach, and within the organs.
_Fungus hematodes._--This starts at the inner corner of the eye as a
papillary elevation or as small nodules which become fused. They grow
larger and become papillomatous, with superficial ulcerations and a
tendency toward hemorrhage. In some cases the eye is displaced by the
growing tumor or is attacked by the cancer cells and entirely destroyed.
Cancerous growths upon the external genitals and the anus usually present a
rough, irregular surface from which there is a constant sloughing of
decomposed tissue accompanied with a penetrating disagreeable odor.
The diagnosis of cancer may be made clinically by noting the simultaneous
infection of the lymph glands which surround the primary lesion. Deeply
burrowing and infiltrating forms which appear as lumps and ulcerations
cause marked disfiguration of the affected part. The surface becomes a
soft, greasy mass; later it cracks open and from the fissures blood-colored
pus exudes, being continually formed by the moist degeneration of the
tissues beneath. At first the general health of the animal does not appear
affected, but later the cancer nodules spread to important organs and give
rise to marasmus and progressive emaciation. Cancer is not a frequent tumor
of cows. Frˆhner states that of 75 cases of tumors in cattle which came
under his observation 2, or 2.6 per cent, were found to be cancers, while
20, or 26.6 per cent, were sarcomas.
_Treatment._--Treatment consists in the early and complete removal of the
tumor, taking care to include a wide border of healthy tissue. This has
been most successful in such superficial cancers as those of the eye,
penis, anus, testicle, vulva, and sheath. If the disease has advanced too
far, this treatment may not prove efficacious, owing to the great
malignancy of the cancer and its tendency to recur. In such cases the
animal may be slaughtered, but the flesh should be used for food only after
inspection by a competent veterinarian.
CYSTS.
Cysts may be true or false tumors and consist of a capsule containing a
fluid or semisolid content. Among the most important cysts, which have been
briefly referred to in a previous table, the following are probably the
most noteworthy, owing to the frequency with which they are found in
bovines:
SOFTENING CYSTS.
Softening cysts, which result from the degenerative liquefaction of normal
or diseased tissues, especially of tumors of different kinds, followed by
the encapsulation of the fluid.
PARASITIC CYSTS.
Parasitic or foreign-body cysts, from the inflammatory reaction induced by
such parasites as the echinococcus (hydatid cyst) or by the presence of
various kinds of foreign bodies.
EXTRAVASATION CYSTS.
Extravasation cysts, caused by injuries which rupture blood vessels,
followed by an increase of fibrous tissue which forms a capsule about the
fluid. The hygromata in front of the knee in cattle, so-called tumor of the
knee, and serous cysts belong to this variety.
HYGROMATA, OR TUMORS OF THE KNEE.--These consist in the simplest form of a
collection of serous fluid mixed with fibrin within a distended bursa. The
walls surrounding the fluid become firm, smooth, and dense.