Multilocular Cysts

MULTILOCATED OR MULTILOCULAR CYSTS

In this group the various tumours are for the most part made up of a congeries of cysts of varying size, so that in typical specimens a section carried through the more solid parts of the tumour has an appearance not unlike a honeycomb. For convenience of description they will be considered in three sets —

{a) Simple multilocular cysts. {b) Adenomata. [c) Multilocular dermoids.

typical specimen will be described to illustrate each variety, but it must be remembered that they pass by insensible gradations one into the other. The cysts are restricted to the oophoron. To the naked eye and with the microscope such cysts are indistinguishable from normal ovarian follicles.

This may be spoken of as the indifferent stage ; from this small beginning the cysts may increase in size until a tumour is produced of such large dimensions that life is rendered burdensome merely on account of the mechanical inconveniences its presence induces. As the ovary increases in size, the various loculi may retain a simple lining of flattened epithelium : in many of the cavities it disappears. Frequently the epithelium exhibits very active changes, and the cysts becom.e occupied by glandular structures, sometimes of great complexity. Such complex cysts are occasionally referred to as multilociilar glandular cysts, but they are more appropriately termed ovarian adenomata^ and it is by the latter term that they will be designated throughout this work. An ovarian adenoma is not only an important, but an extremely interesting, variety of tumour. As a rule, it has a dense fibrous capsule, and the surface is frequently lobulated.

 These tumours attain great dimensions, and are composed of innumerable cysts, which vary in size from a cavity no bigger than a pea, to one holding a quart or more of fluid. Critical dissections of such cysts enable us to recognise three varieties of loculi. In typical specimens a honeycomb-like mass will be found projecting into some of the larger cavities, and occupying usually one-third of its circumference, so that a section of the cavity resembles a signet-ring—such are called primary,—whilst the cavities occupying the honeycomb portion are secondary cysts, and are, as a matter of fact, mucous retention cysts. The third set of loculi contain no honeycomb-like structures, are of small size, and histologically are indistinguishable from distended ovarian follicles.