A Case of Ectopic Liver Tissue in the Newly Born

Abstract

LESS than a dozen cases of solid tumour of the umbilical cord are recorded. Although this casc is not strictly an example of neoplasm of the cord, the diagnosis from new growth could not easily be made clinically. Theories of aetiology can be measured against the detailed findings and are of more general interest. For these reasons a detailed report is given.The maternal history was abnormal but probably unrelated to the foetal condition. The mother had had toxaemia in a previous pregnancy, and had also suffered from asthma since adolescence. Continuous asthma of a severe degree had been experienced for z days before admission and continued, despite the usual remedies, during the one day in hospital before delivery.Birth was assisted by the forceps when the head reached the perineum. The infant was cyanosed to about the same degree as the mother, hiit recovered rapidly after a few respirations.A pyriform turnour, zf inches in diameter, was found at the foetal end of the umbilical cord. The cord itself was oedematous, and the veins were dilated for 6 inches distal to the tuniour. The surface of the mass was smooth and the contour regular. The consistence was firm, and fluctuation could not be elicited; on the other hand, the volumr decreased slightly during steady pressure and increased after release of control. The mass was opaque. The narrow end passed into the umbilical opening so that the upper limit could not be defined, but impulse was absent when the infant strained. The tumour did not pulsate. Abnormalities other than the above were not found in the infant.As the tumour breached the abdominal n d l and was covered only by Wharton's jelly and the amnion, early operation was necessary to prevent the development of peritonitis. One day was allotted to permit the child to recover from the stresses of parturition.246