PRECOCIOUS PUBERTY 155 



and hyperplasia. There is a number of such cases on Ovarian 

 record. One of the most interesting is that of a girl ^ S u r f s a 

 under the care of Clement Lucas 1 . This patient, who sexual 



, i -, i precocity 



Was seven years of age, had a large ovarian tumour i n g i r i s . 

 which was associated with early menstruation and the 

 usual signs of puberty. After the removal of the tumour 

 menstruation and the other adolescent manifestations 

 disappeared. A similar case has been recorded by 

 Harris 2 . 



I have seen a girl, seven years of age, belonging to 

 the upper middle class, who had menstruated regularly, 

 but very slightly, with definite molimina for two years. 

 There was slight development of the breasts, but no 

 axillary or pubic hair. No tumour could be felt in the 

 abdomen, but a pelvic examination was not allowed. 



Roger Williams 3 states that in eleven cases, which 

 he had collected, of sexual precocity in female children 

 associated with ovarian neoplasms, histological examina- 

 tions of the tumours showed that eight were sarcomata, 

 two cystomata, and one a fibroma. The same writer 

 points out that in girls sexual precocity is not associated 

 with excessive muscular or skeletal development as is 

 the case in boys. This, of course, is what we would 

 expect, for muscularity is not a feminine characteristic. 

 Gaudier 4 has recorded a case in which a tumour of 

 the ovary, resembling a suprarenal cortical neoplasm, 

 gave rise to sexual precocity. If the neoplasm were 

 really a suprarenal growth, about which there is con- 

 siderable doubt, the feminine precocity may have been 

 due to hyperplasia of the ovary caused by the tumour. 

 Gautier (?), quoted by Williams 3 , found that of 

 twenty-three sarcomatous ovarian tumours in young 

 children only four were associated with the signs of 

 sexual precocity ; consequently it must not for a moment 

 be assumed that all ovarian tumours in young girls 



1 Lucas, R. C., Trans. Clin. Soc., Land., 1888, vol. xxi, p. 224. 



2 Harris, R. H., Surg. Gynecol. and ObsteL, 1917, vol. xxiv, p. 604. 



3 Williams, Roger, Brit. Oyncecol. Journ., 1902, vol. xviii, p. 85. 



4 Gaudier, H., Echo Med. du Nord, 1908, No. 30, p. 357. 



