(3) The Myo-sareomata are much rarer than either of the preceding, only five examples having been recorded up to the present time. They form smooth or slightly nodular tumours in the gastric wall near the great curvature, and frequently show signs of cystic degeneration. Like the fibro-sarcomata, they may grow to an enormous size, Brodowski having met with one which weighed twelve pounds.
(4) Anglo-sarcoma has been twice recorded (Bruch and Kosinski). In one case it formed a tumour as large as an infant's head, with many cysts, due to interstitial haemorrhages, scattered through its substance.
Each variety is apt to give rise to secondary growths in organs more or less remote from the primary disease ; but the round-cell is by far the most malignant type, for out of twenty-three cases of the latter in which full details are given, sixteen, or 70 per cent., exhibited metastases. In almost every instance the lymphatic glands immediately connected with the stomach were enlarged, and in nearly 50 per cent, were sarcomatous ; while in a few cases the retro-peritoneal, mesenteric, and even the mediastinal, cervical, and supra-clavicular glands were affected. One or both kidneys presented secondary deposits in 28 per cent.; the liver, ovaries, pancreas, adrenals, and omentum each in 14 per cent.; and the lungs, diaphragm, pleurae, oesophagus, intestine, and mesentery in about 7 per cent, of the cases. It is also important to notice that nodules of growth were present in the skin of the abdomen, thorax, or back in about 12 per cent, of the entire number.
The spindle-cell variety was accompanied by metastases in the perigastric glands in 37 per cent, of the cases, and in the skin, liver, and diaphragm in 12 per cent, of the cases. In two out of the five cases of myo-sarcoma secondary growths were found in the liver.