Phantom Tumor

PHANTOM TUMOR [phantom tumour (English), Phantomtumor, Scheingeschwulst (German)], "imaginary tumor" (of the abdominal cavity), an old, obsolete English term denoting the erroneous recognition of a tumor where none actually exists. The occasion for such an error may be, for example, imaginary pregnancy, in which there is enlargement of the abdomen due to obesity, growth of the mammary glands, absence of menstruation, and subjective signs of pregnancy, and the physician thinks he is palpating a tumor or a pregnant uterus. This simulation of pregnancy (grossesse nerveuse, s. imaginaire, s. graviditas spuria) and the abdominal enlargement associated with it are extremely rare, but are nevertheless observed in clinical practice. A classical case of grossesse nerveuse was described by V. F. Snegirev in the Serbian Queen Draga, to whom he was invited in Belgrade "for childbirth," but in the end there was no pregnancy, and all her sensations during pregnancy, the sensations of fetal movements, and the "labor pains" proved to be false; everything was caused by the desire of the childless queen to have a child. Spasmatic contractions of the abdominal muscles, especially the rectus abdominis muscles, are sometimes mistaken for tumors; these sometimes contract in separate segments and then actually produce the impression of a tumor upon palpation and can mislead and give rise to an erroneous diagnosis. Correct recognition of such "tumors" is easy; sometimes it is sufficient to distract the attention of the patient being examined and the tumor disappears under the hand; percussion is often helpful, and finally, examination under anesthesia, recommended by Simpson, always resolves the question. Under the term phantom, Germans also understand encysted peritonitis, particularly tuberculous ones, which due to the delicacy of the adhesions sometimes disappear spontaneously, sometimes burst under the hands during examination or during surgery upon the disruption of adhesions. To the same kind of imaginary tumors one can perhaps attribute more voluminous coprostases and even localized distensions of the intestinal loops, which disappear after a laxative or enema, but prior to bowel action were recognized as "tumors." Finally, an overfilled, tense urinary bladder, especially in ischiuria paradoxa, and severe varicose veins in the broad ligaments of the uterus were taken for a "tumor." With modern examination techniques, the diagnosis of "phantom tumor" should have no place, and the term itself can therefore be eliminated.

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