168 ENDOCRINE GLANDS 



it may cause a pseudo hermaphroidism. Occurring after 

 the complete formation of the genital organs, it gives 

 rise to adrenal virilism. 



From a practical point of view, we must remember that 

 the observation of the syndrome of adrenal virilism means 

 only: a tumor developing at the expense of the cortex of 

 the adrenals. These tumors, due to the embryological 

 reasons stated, can be located in any part of the abdomen 

 or pelvis, even inside of the tissues derived from the organ 

 of Wolff: kidney, ovary, etc., if they have as a starting 

 point an accessory adrenal. 



The observation of the genito adrenal syndrome necessi- 

 tates not only the examination of the abdomen, but also 

 of the pelvis and the labia which may contain ovarian 

 tumors made up of adrenal tissue. 



TREATMENT. 



Medical treatment is of no avail and surgery is the only 

 hope. The results depend on the location of the tumor. 

 If an ovarian tumor develops from the accessory adrenals, 

 the prognosis is favorable. This is not the case if the 

 tumor involves the adrenal itself, for removal of the adrenal 

 is a serious operation, the mortality of which is as high 

 as 50%. 



PROGERIA SENILE DWARFISM 



This syndrome can be placed next to the preceding ones, 

 as its adrenal origin is very probable. It is very un- 

 common. The first case reported seems to have been 

 that of Hutchinson in 1886. Hastings Gilford in 1896 

 described two cases under the name of Progeria (premature 

 senility). Variot and Pironneau in 1911 have studied it 

 under the name of senile dwarfism (see Fig. 5 and 6). 



These cases are children who have the appearance of 

 old men. A patient of Rand (1914) 8 years old, had the 



