The largest tumor on record

In 1851 a physician from Ohio, Dr P.J. Buckner, was at a meeting of the State Medical Society when he got chatting to a colleague, Charles Beach. Dr Beach told him of a case so extraordinary that Buckner decided to travel 220 miles to see the patient for himself.  He was determined to get visual proof, so – naturally enough – he took a photographer; or at least, the next best thing

Accordingly, having procured the services of Mr. Johnson, a daguerreotype artist of the city of Cleveland, we reached the house of the patient, and received from herself the following history of her case. We confess that the appearance, on actual inspection, so far exceeded our anticipations, that we fear all we shall be able to say will convey but a faint idea of the appearance of the patient, as she lay upon her couch.

‘Mrs D.’ told Dr Buckner that she was 32 and had five children. While pregnant with her first child she received an impact to the abdomen which she believed was the cause of her disease. Nothing unusual at first happened, except soreness in her right side:

In September, 1840, she was delivered of her second child. Six weeks previous to her confinement, she lifted a heavy kettle and hurt herself. After she recovered from a swoon, as she supposes, she found herself lying upon the floor. When she arose, she discovered a small tumor protruding from the vagina, which, upon lying down, did not disappear. This singular tumor has continued ever since, and as the further history will show, forms a remarkable feature in the case.

After the birth of her second child, she was in delicate health. But then her case became more serious.

She became pregnant the third time, and had advanced to the third month of gestation, when she became frightened at the sight of a large rattlesnake. She felt immediately the symptoms of labor, which in a few hours resulted in abortion. This occurred in 1841. Three days after, she took cold, having pain in the back, and tenderness and fullness of the abdomen. Her right side became sore to the touch, which increased, until it was so sensitive that even the weight of the bedclothes was oppressive.

She fell pregnant for the fourth time, but the baby was stillborn.

During the progress of this labor, the tumor which had protruded from the vagina, during her second pregnancy, now became a source of obstruction, having greatly enlarged and elongated. Its appearance at this time was that of erectile tissue, pear shaped, protruding five inches beyond the es exteruum, two inches in diameter, and having its pedicle somewhere within the vagina, but beyond the touch. She continued in labor some forty hours, and was finally delivered of a full grown dead child. On the eleventh day, Dr. Johns, of Wellington, was sent for. who found her suffering from suppression of urine, accompanied with general inflammation of the external genitals.

The local doctor treated her, and found a soft tumour filling almost all of the right side of the abdomen.

From this time there was pretty rapid enlargement of the abdomen, which continued to increase for the space of a year. A tumor, also, made its appearance in the right labium, and extended to the nates. It was soft and elastic, and by firm compression could be returned within the abdomen or pelvis. This tumor, protruding and enlarging, we will denominate the tumor from the hip. It continued steadily to enlarge, as did also the abdominal tumor. A distinct fluctuation could be felt in both.

The doctor believed this was a case of dropsy (fluid in the abdomen, now known as ascites). But all attempts at treatment failed.

She was seen by a number of physicians of respectability, who insisted that it was a case of ascites, and that she ought to be tapped. At length, she submitted to the operation, which was performed twice by different physicians. The first punctured the abdomen in three places, without success… Soon after this, she returned to her former residence, and placed herself again under Dr. Johns’ care, with all the symptoms greatly aggravated. The vaginal tumor became gangrenous, and sloughed into deep ulcers. As soon as one ulcer healed, another was produced by the sloughing process. The disease was a source of intolerable suffering to the patient, as well as perplexity to the physician.

Dr Johns was convinced the tumours were in fact trapped fluid, but every time he attempted to drain it from the abdomen he found nothing.

A period of nearly three years has elapsed, and she remains with rather an improved state of health; and presents the astonishing appearance indicated in the plate.

This was the most enormous tumour you have ever seen. It was four feet in diameter, and over two feet long.

Altogether, it is a most extraordinary case; and we have been at some trouble and expense in obtaining the facts…. The whole weight of the patient is two hundred and fifty-five pounds. Her greatest weight previous to marriage was ninety-three pounds. Estimating her present weight at eighty pounds, her flesh being much reduced, would leave one hundred and seventy-five pounds as the weight of the morbid growth. This case presented, probably, the largest tumor on record.