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The purpose of this paper is to report what is believed to be a rare case of carcinoma of the uterine fundus with metastasis to the brain. In a review of the literature, we found several reports mentioning the occurrence of metastatic cerebral lesions from a carcinoma of the uterine fundus. However, in no report are the criteria of diagnosis of this lesion given, and we have found no case in which both the primary and the secondary site were examined grossly and microscopically during life. INCIDENCE OF METASTATIC TUMORS OF THE BRAIN Meagher and Eisenhardt, 1 in reviewing 1,850 cases of intracranial neoplasm, found that 57, or 3 per cent, were metastatic. Elkington 2 reported 72 cases of metastatic tumors of the brain in a series of 805 cases of cerebral tumor, an incidence of 9 per cent. Dandy 3 estimated the incidence of metastatic cerebral tumor to be

For the correction of uterine prolapse and cystocele, the operation of interposition is practically the universal procedure of choice. By this method, the bladder is elevated in the pelvis and is prevented from again descending by the uterine fundus. The principles of the operation as described by both Wertheim and Watkins are essentially these: 1. The bladder is supported by and rests on the posterior wall of the uterus. 2. The uterus is anteverted in the pelvis, being tipped forward about 180 degrees. By virtue of this torsion, the broad ligaments are twisted and perceptibly shortened. 3. The long axis of the uterus makes an acute angle with the vagina, thus preventing any descent of the cervix into or through that passage. The end-result of a properly performed interposition is illustrated in Figure 1. Although a successful procedure for prolapse, interposition of the uterus presents a decided hazard to future

The treatment of carcinoma of the uterine fundus is mainly a surgical problem, owing to the slower growth of the cancer, its practical encapsulation for a considerable time within the thick muscular uterine walls and its usually late tendency to metastasize. However, there is in many instances a choice of treatment. Radiologists have considerable interest in treatment of carcinoma of the uterine fundus, especially in two groups of cases: in the first instance, in extensive malignant lesions too widespread for any curative surgical intervention but susceptible of receiving much help from limited radium therapy; second, in favorable small lesions which would be excisable except for the poor general condition of the patient, often suffering from other serious diseases not related to the cancer. While much real good can be accomplished in the former group, the second group is also of considerable size and is of greater interest as five year

There persists, especially after several or instrumental labors, an elongation of the round ligaments and of the six consecutive-tissue ligaments associated with the uterus, and more especially the ligamenta cardinalia. There is deepening and sinking of the peritoneal pelvic recesses anterior and, especially, posterior to the uterus. Since the normal anteverted or anteflexed position of the uterine fundus is maintained only if the cervix is high up and far back, such descent of the cervix and fornices permits the fundus to drop back into retroversion, unless there be present unusually short and muscular round ligaments. Slight ptosis of the uterus may occur with the fundus in anteflexion or anteversion, but marked ptosis of the uterus implies an associated retrodeviation. A retroversion or slight retroflexion permits abdominal pressure, among other accessory factors, to cause a ptosis of severe degree. Ptosis does not occur if there are no lengthened ligaments; if the