Hcart and mediastinal structurcs all appear t o be displaced considerably towards the right side of the chest, creating dense shadow in all of the central zone of that side of the chest. The peripheral region of lung appears to be functioning except a t the base, where the diaphragm is riding abnormally high and the costophrenic angle is apparently filled up with adhesions.
Dec. 17, 1929.-The lad is now leading a normal life, H e has been back a t school for six weeks and is apparently well. There is little asymmetry of his chest, and there is good resonance over the right, side. (Fig. 512.)
DISCUSSION.
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The X-ray pictures did not show the presence of any cartilage or bone.
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The bronchitis present was mild and no sputum was produced; the breath was sweet, indicating no bronchial opening into any abscess cavity.
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Deformity and bulging of the chest on the affected side denoted a condition of long standing.
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A positive diagnosis of dermoid tumour coidd be made in one of two ways only: ( a ) The fluid obtained a t aspiration would have, under close investigation, yielded the correct diagnosis ; ( 6 ) Exploratory opening, with the identification of tissue foreign to the lung.
The tumour was so solid that its size could not be diminished by a drainage of any cyst that might have been found in its make-up.
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A transfusion of blood during the operation was necessary to save this life.
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The very large cavity left in the right thorax in a boy of 7 required no treatment other than dependent drainage to close in nine weeks.
5 .
The line of cleavage in this tumour was readily followed.