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Several authors have studied the question of whether endometriosis can develop into cancer. S a m p s o n published an extensive study in 1925 containing a thorough description of seven cases and excellent pictures of endometriosis and tumour formation. He concluded that in his seven cases the carcinoma had either arisen in the endometrial tissue or had invaded it from another source. I n 4 of the cases, he said, the carcinoma could lie considered as having developed in the epithelial lining of a benign cyst of endometrial origin. In the other 3 S a m p s o n was convinced that the carcinoma had arisen in ovarian endometrial tissue which had not developed into an endometrial cyst.S a m p s o n listed the strict criteria necessary to prove that the endometrial tissue had hecome malignant. R. M e y e r (quoted by M i l l e r , 1937) made a careful study of S a m p s o n ' s cases and, like C o r n e r , H u and H e r t i g (1950), called into question whether more than one of them fulfilled these requirements. T e i l u m (1946) described a case of typical endometrial cyst in which the histological picture showed a transition from endometrial epithelium into a malignant growth. K u z m a (1947) described two cases in which adeno-acanthoma and ovarian endometriosis were associated. I n one case he was certain that there

1 liere has Iwcn wiiie discussion in the past, as to how ofteii Iiysterectoniy i.; follo\vetl I)y climacteric syml)toins. The clitiic;il cslwrience has slioivn, Iiowever, that I'ractically 110 syin1)toins o f t1ii.s kind occnr ii one o r I)oth ovaries are left. \Vlien i t is iiecessary to take away the uterus 1)efore the ineno1);iiise has occurred, i t is iinl)ortant to tell the ~xitient exactly what the conditions are ;inti to inipress upon her that the tlisalq)e;irance o f menstruation (loes not nie;iri that the i n e i i~~) a i i~e has conic. She should IK told that her ovariet; will IK left and continue to function. 1)oiiiK so has a IiiKIily I)enefici;il effect on her mcntal reaction and the ini-Imrtance of tlescril)ing the full state o f affairs to the patient l d o r e olwration cannot I)e stressed too often o r too much.It \\auld l)c interesting lio\vever to learn exactly lio\v the ovaries function after hysterectomy. Several authors have in-vestiKated this question. S e s s 11 111 s and 31 11 r p h y (1932-1933) ~nil~lislied t\vo clinical studies of \vomen submitted t o liysterectotn!. Iwfore 30 years of age in tvlioni o n e o r Imth ovaries \\.ere left. 1 hey olwrvetl that t1ie.w women had more t r o u l k o m e climacteric sjmj)tonis than a conil)nrative series not su1)initted to operation. I he syinptornt; aplwarcd inore ofien hefore 40 r w n . of i-tgz~ /j, t j l~ group in which hysterectomy was performetl. I;urthc~rmore, they ol)servetl that the menopause occurred more often 1)eforc 40 years (ii age wiien one ovary \v;is removed than \\.hen Imtli were left. * .I .

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