Attempts to localize tumor metastases in long bones by mechanical trauma.

The medical literature contains many discussions dealing with the influence of trauma on tumor development and numerous reports indicating that in some unexplained manner trauma may be a significant factor in initiating malignant growth, but relatively few articles concerning the influence of trauma on the localization of metastases. Toth (5), who studied 2 patients with generalized carcinomatosis to determine the influence of various mechanical injuries on the formation of metastases, was unable to demonstrate any definite causal relationship (see this article for further references). Lubarsch (4) could not localize metastases in tumor-bearing mice by fracturing bones whereas Ewing (1), on the other hand, cited 5 instances of localization at sites of trauma. Foulds (2), in a critical review on filterable tumors of fowls, stated that in fowls bearing Fujinami sarcoma, secondary growths have been induced by the injection of kieselguhr, lycopodium, powdered charcoal, etc. He also mentioned that, following intravenous injections of filtrates of Rous sarcoma I, tumor formation has been induced at the sites of injection of Scharlach R, tar, embryonic tissues, kieselguhr, histamine, and at points of injury. Jones and Rous (3) were able successfully to transplant a mouse tumor intraperitoneaUy only after preliminary irritations of the peritoneum by injections of lycopodium, and believed that this irritation was an important factor in causing localization of the tumor. In view of the conflicting evidence and because of the importance of this problem from the medicolegal standpoint, the following experimental study was undertaken to ascertain whether or not trauma applied to long bones might be influential in the localization of metastases from a transplanted malignant tumor. The Brown-Pearce rabbit tumor was used throughout this study. This is a highly malignant tumor, readily transplantable into the testes, from which it metastasizes early and, within 3 to 6 weeks from the