Further Observations on the Removal of an Enormous Facial Tumour by Robert Liston in 1834

Abstract

In 1834, shortly before Robert Liston (1794-1847) left Edinburgh to take up the post of senior surgeon to the North London (now University College) Hospital, he operated on Mrs Fraser, from Banchory, in north-east Scotland. Her tumour was believed to have originated as a result of trauma to the left maxillary antrum. It was immense in size when he first saw it, and produced an enormous degree of facial distortion. The tumour was associated with drooping and disfigurement of the left angle of her mouth and extended forwards from her left external ear to the left side of her nose. Its upper part eventually obstructed the vision of her left eye, while its lower part extended for some inches below the level of her mandible. The volume of the tumour was just slightly less than that of her face. Liston provided a detailed description of her appearance when he first saw her, and gave a detailed history that suggested its possible aetiology. Descriptions of her pre-operative cast were previously published in this Journal in 2000. Since then, additional casts showing her post-operative appearance and that of her tumour have been located, and these form the basis for this follow-up account.