Pre-Cancerous Lesions of the Digestive Organs

A PRE-CANCEROUS lesion is one which is pronie to become malignant. A comparatively large ntiml)er of lesions of this kind are recognized in superficial structures-for example, arseniical and X-ray dlermatitis, leukoplakia vulvw, leukoplakia lingu?e, chlronic cervicitis and erosion of the cervix, and "chronic cystic mastitis." Even in these lesions, however, the incidence of malignant (lisease is extremely variable. 'Fhis variability is explained in large part by the fact that the evolution of a malignant process may be protracted over a period of twenty years or more-so long that the patienlt may clie from some intercurretnt disease before invasive growth has begun. Nevertheless, the itncidlence of malignant disease in these lesions is frequent enough to ind(licate the possibility that they are all "pre-cancerous." Thle recogniition of pre-cancerous lesionis in the digestive system has been rather more tar(lv for several reasonis. The accurate dliagnosis of the primary condition is naturally-much more (lifficult. TIhis primary condition is commonly but not invariably attended by symptoms of chroniic indigestion. Such symptoms are continued or mnay be intensifie(d wvhen invasive growth begins, and the transition to malignant (lisease is liable to be missed. In any case, the precise relationship between an internial simple lesioni and(l a maligniant growth can be verified only by surgical operation or by a thorotIgh post-mortem examination-and then only if the growtlh has not obliterated the characteristic features of the pre-cancerous lesion. Speaking generally, the superventioin of malignianit growth in pre-cancerous lesions of the (ligestive organs is less frequent than in those affecting superficial structtires, because the former are intrinsically more danigerous to life, and a fatal complication is more liable to develop at a comparatiVely earlV stage.