TTIE common growths of the bladder belong to the epithelial group of tumours, and fall readily into two genera, papilloniatn and carcinomata. The latter arise either primarily from the squamous cells of the mucous membrane, or secondarily from the papilloma or wart. Examplcs of the change in the character of the latter are well known in other parts of the human body. Experimentally they have been produced in animals, more especially in rats and mice.
A search in the literature on the subject of vesical tumours has revealed a description of an epithelial lesion which has been termed an adenoma. The definition of an adenoina is that it is a tuniour constructed upon the type of, and growing in connection with, a secreting gland. Another characteristic is that it is encapsuled.
The investigator's attention is naturally drawn t o the evidence which is availahle of the presence of secreting glands in the wall of the bladder. Lendorf in 1901 described certain glandular structures around the urethral orifice and at the base, which consist of solid epithelial down-growths and glands with one to five lacuntr: draining into a single excretory duct. In the posterior wall of the bladder only the epithelial in-growths are found, and the apex is free from glandular structures. These glands are stated to have a mucus-secreting function, but this is disputed by Eggling. Glandular structurcs have been seen also by Tourneaux and Hartman, Rauber-kopsch, and Zuckerkandl. Jordan and Ferguson state emphatically that the mucous membrane, exccpt in the urethral orifice, contains no glands. I n this situation there are a few mucus-secreting glands which are only observed in the male subject and are interpreted as vestigial prostatic tubules. They are not present in children.
From the evidcncc that has been accumulated it is clear that the internal meatus and base are the only part5 of the bladder in which glands can be consistently demonstrated. If glands arc so common in other regions as some authorities would have us believe, one would expect t o find many more case\ of so-callcd adenomata recorded.
Thc literature on the subject of these rare tumours is confined to a description of barely twenty cases, somc of which, in the opinion of the writer, cannot be claimed as primarily arising from the bladder wall. Thus the note5 of the caqes given by Bridoiix, Gcraghty, Uteau, and others, in which the tumours occiir in the male sex, arid arisc either from the base of the bladder or around the internal meatus, lead one to the definite conclusion