354 



HEKRY D. JUMP 



coarse : the pubic and axillary hair were like that of an adult : the pubic 

 hair reached the navel, tapering off as is seen in males : there was a growth 

 on the anterior surface of the chest. The beard and mustache were de- 

 veloped as is seen in a boy of seventeen or eighteen. The skin was rough 

 over the legs and abdomen when she was one year old and was coarse, red 

 and pimply when she was seven. There was no abnormal pigmentation of 

 the skin. The genitalia were developed as in an adult. The clitoris was 



about one inch long, half an inch in diameter 

 and notched on the under surface. This en- 

 largement was first noticed at about the 

 seventh year. The vagina was small and 

 when the abdomen was opened the uterus, 

 ovaries and tubes were found to be infantile. 

 No testicle was found. She did not men- 

 struate. The labia were thick and large. 

 When she began to talk her voice was coarser 

 than that of a child and grew deeper until 

 it was a deep bass. While she was still a 

 little girl in many of her qualities, her gen- 

 eral behavior was more masculine than 

 feminine. The thyroid was not enlarged. 

 Despite repeated examinations no mass could 

 be detected in the abdomen until she was 

 past seven. At that time there was found a 

 dense elastic mass on the right side extending 

 from the costal border to the pelvis. This 

 grew rapidly and was painless. The tumor 

 was removed about six months after its dis- 

 covery and was found to involve the whole of 

 the right kidney. There was no line of sep- 

 aration between the suprarenal and the kid- 

 ney. Microscopically it was found to be a 

 hypernephroma of the suprarenal cortex. She 

 died three hours after the operation. At the 



limited autopsy it was found that the left kidney, left suprarenal and 

 pituitary were normal: there were no metastatic growths in the abdomen. 

 It will be noted that the hairiness of the face came late, appearing only 

 just before the tumor was discovered, but that other manifestations of vir- 

 ilismus existed for several years before. Only a small number of these 

 cases have been reported. Those in which careful postmortem exami- 

 nations were made showed hypernephroma of the suprarenal cortex. The 

 neoplasm was unilateral and acquired in all except one, that observed by 

 Dobbertin, in which the tumor was congenital. The important ones are by 

 Colcott Fox, Pitman, French, Kichards, Glynn, Miller, Orth, Dobbertin. 



Fig. 1. Virilismus in a girl 

 of 7V_> years. Case of Jump, 

 Beates & Babcock. Am. Jour. 

 Med. Sc. 1914. 1. 1190. 



