Neurogenic Sarcoma of the Peritoneal Cavity

anorexia developed, and the patient, too fatigued to prepare her meals, would often go to bed immediately upon returning from her work. Despite these symptoms she continued at her occupation until two weeks and a half before admission, when she was seized with severe pain in the right lower quadrant of the abdomen, which gradually spread to the upper right quadrant. It remained more or less constant during the ensuing four days, a t which time the patient noticed that her abdomen had become considerably enlarged. A heavy, dragging sensation in the left lower quadrant forced her to sleep on the right side. Ten days prior to admission she was unable to retain any food other than fluids. No blood or coffee-ground material was observed in the vomitus, nor was there any gross blood in the stools. On examination the patient was found to be somewhat emaciated, and obviously suffering severe pain. There was some tortuosity of the retinal veins, but the discs were normal. There were no physical signs of changes in the lungs. The heart was not enlarged; the rate was somewhat rapid though regular, and a blowing systolic murmur was heard at the base. The blood pressure was 140/70. In thc left lower abdomen was a firm, oval mass slightly tender on pressure and extending from the left parasternal line below the costal margin to the iliac crest.