814 PETER BASSOE 



boy, 17 months old, whose legs began to enlarge at 7 months, then the face, 

 the lower part of which was disproportionately large. The malar bones 

 were pronrinent and the lips, but not the nose, were large. The hands and 

 feet were very large. There was no rontgenologic examination. Pel (6) 

 described a boy of 16 years, with limbs large from birth which continued to 

 grow more rapidly than the trunk, especially after an acute illness at 13. 

 The head, lips and lower jaw were rather small, the genitalia infantile, 

 pubic and axillary hair absent, sella not enlarged. Poor muscular develop- 

 ment, increased tendon reflexes and diminished pain sense in the legs sug- 

 gested to the author the possibility of a complication with syringomyelia. 

 The boy was 172 cm. (5 ft. 8 in.) tall at 16 years. The growth disturbance 

 is evidently largely explained by the eunuchoidism present. A multigland- 

 ular disorder also existed in the well studied case of Schultze and Fischer. 

 A girl at 11 years developed headache, vomiting, enlargement of the head, 

 hands and feet, and salivation at the paroxysms of headache. When ob- 

 served shortly before her death from increased brain pressure at 15, she 

 had not yet menstruated. The head was typically acromegalic. The skin 

 was pigmented and there was heavy growth of hair along the median line 

 of the abdomen below the umbilicus. The necropsy brought out the poly- 

 glandular affection : large adenoma of the hypophysis, colloid goiter, per- 

 sistent thymus, hypoplasia of the internal genitalia. As an additional 

 acromegalic feature there was found a general enlargement of the viscera 

 (splanchnomegaly). Onset with enlargement of the face at 11 years was' 

 also noted in Hoppe's second case. There gradually developed hyperosto- 

 sis of the upper and lower jaws, frontal and temporal bones and the septum 

 of the nose. There was no enlargement of soft parts, or of the hands and 

 feet. The left eye was prominent, and optic atrophy was present. During 

 life a diagnosis of leontiasis ossea was made but after death from a sud- 

 den subdural hemorrhage at fifteen there was found, in addition to cranial 

 hyperostosis, an unusually deep sella turcica containing "a large hyper- 

 trophied pituitary gland." Hoppe remarks that this finding "strengthens 

 the contention that perhaps leontiasis ossea is a form of acromegaly, but 

 throws some doubt on the contention that pituitary hypertrophy in young 

 individuals leads to gigantism." No histologic description of the hy- 

 pophysis is given. A fairly clear case of acromegaly in a boy of thirteen 

 years is reported by Babonneix and Paisseau. The face was prominent, 

 with a large, thick nose, and the tongue was of more than twice its normal 

 size. The occipital protuberances and mastoid processes were large. The 

 feet were considerably enlarged, the hands less so. The sella turcica was 

 enlarged. However, an interstitial keratitis was also present which im- 

 proved on specific treatment, suggesting a complicating congenital syphilis 

 the existence of which may have prevented the expected general giant 

 growth by the presence of syphilitic changes at the epiphyses. Matas- 

 saru's case of a child of nine years with characteristic enlargement of the 



