Although several cases of ' simple fibrous tumour of the stomach ' have been recorded, a careful scrutiny of the descriptions given of their microscopic appearances throws considerable doubt upon their benign nature. In some instances there is every reason to believe that the growth was ordinary scirrhous carcinoma, while in others it is probable that it was the scar of a former ulcer which had become keloid. In most cases, however, where a circumscribed tumour existed, it was apparently of the nature of a fibro-sarcoma. Thus, in Ware's well-known case a woman at the age of fiftysix suffered from a hard irregular tumour of the abdomen which extended from the level of the umbilicus to the left iliac crest. After death a fibrous growth was found to occupy the anterior wall of the stomach near the great curvature and to be ulcerated upon its mucous aspect.1 The absence of symptoms, combined with the fibrous structure of the tumour, appears to have been the main reason for describing the growth as a fibroid, but in the light of our present knowledge it would seem to be fairly typical of fibro-sarcoma (p. 273). We have not been able to find a single case in the whole of the literature where a large fibroid tumour of the gastric wall was above suspicion of malignancy.

Papilloma of the pylorus

Fig. 69.-Papilloma of the pylorus. (Museum of the Eoyal College of Surgeons.).

1 Boston Med. and Surg. Journal, 1858, p. 83.