. Les tumeurs, malignes et innocentes ; leurs caractères cliniques et le traitement approprié. ssification associés à l'periosteumis mous des pas de surprise lorsque nous nous souvenons de l'os de la fonction de formation de ce tissu. Le cristal-comme sjDiculesso fréquemment trouvés représentent probablement des thefibrous trabeculse d'ossification qui relient le périoste avec thecompact ; tissus de l'arbre comme le périoste est raisedfrom l'os par l'augmentation de la tumeur, ces trabeculseelongate et ensuite ossifier. Le fémur.-cet os est très susceptible à l'surtout,sarcomes variété du périoste ; ils

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. Tumours, innocent and malignant; their clinical characters and appropriate treatment. ssification associated with sarcoma of the periosteumis not a matter for surprise when we remember the bone-forming function of this tissue. The crystal-like sjDiculesso frequently found probably represent ossification of thefibrous trabeculse which connect the periosteum with thecompact tissue of the shaft; as the periosteum is raisedfrom the bone by the growing tumour, these trabeculseelongate and subsequently ossify. The femur.—This bone is very liable to sarcomas, especially the periosteal variety; they are most frequentlyassociated with its lower third, and invariably run a rapidlyfatal course, the duration of life rarely exceeding eighteenmonths; often it is very much less. Usually they occur 8ABG0MA8 OF BONES 79 between the fifteenth and fortieth years. A sarcomasituated at the lower end of the femur often simulatesdisease of the knee very closely, and gives great difficultyin diagnosis; also a sarcoma of the femur may invadethe knee-joint and resemble a primary sarcoma of the. Fig. 45. —An ossifying spindle-celled sarcoma of the femur: in transverse section. synovial membrane of that joint. The rapidity with whicha periosteal sarcoma of the femur will destroy the patient, especially when it occurs in early life, is illustrated inthe following case:—A man 24 years of age felt pain inhis knee; a month later it was found that a sarcomaoccupied the lower end of his femur. Two months afterwardshe came under my care, and the leg was promptlyamputated. The tun^our, a periosteal sarcoma, had circum- 80 OONNEGTIVE-TISSTIE TUMOURS scribed the lower portion of the femur (Fig. 45). A fewdays after the operation, difficulty of breathing began todeclare itself, and a month after the operation the mandied, slowly suffocated. At the post-mortem examination

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