GIGANTISM 831 



An excellent example of gigantism and infantilism with acromegalic 

 features is the Portuguese giant, Jose Lopez, 21 years old, 210 cm. (6 ft. 

 11 in.) tall, weight 117 kilograms, reported by Magalhaes Lemos. His 

 birth was normal. As a child he suffered from severe headaches, and he 

 claims never to have had any vision in his left eye. After smallpox at 

 six or seven years his rapid growth attracted attention and it continued 

 to be rapid until the age of 12 years. When examined at the age of 

 21 it was striking that his legs and particularly the feet were dispropor- 

 tionately long (36 cm.), as were his arms and hands. The facial part 

 of the head was relatively large, the lips thick, the nose broad and the 

 tongue large. The genitalia were decidedly rudimentary and there was 

 neither axillary nor pubic hair. The muscular power was poor and 

 the tendon reflexes were feeble. The eyes showed congenital optic atrophy 

 in the left eye with blindness, a temporal scotoma in the right eye and 

 paresis of both external recti. Rontgenologic examination showed open 

 epiphyseal lines at the lower end of the radius and ulna. Mentally he 

 was dull, melancholy and timid. The thyroid gland was palpable, but 

 small. 



Lemos considers this giant as an instance of BrissaudV type of in- 

 fantilism on account of his undeveloped genitalia and absence of puberty 

 while the features of the Lorain type were lacking. 



Gigantism in Childhood 



The reported cases in children who at a given age have reached an 

 altogether abnormal size, sometimes associated with precocious mental 

 and sexual development, must be considered apart from gigantism proper. 

 They are very dissimilar, and while some of them recall stages in the 

 development of true giants, others are instances of precocious growth de- 

 pendent on serious disorders incompatible with prolongation of life beyond 

 childhood. 



A very distinct group is that associated with adrenal tumors. Linser 

 describes a boy, 5'% years old, 138 cm. tall, who began to grow rapidly and 

 develop an abnormal growth of Ijair at four years. The penis and testicles 

 were large, the former 9 cm. long, and erections occurred. The prostate 

 was of a size normal at 15 years, Death followed attempted removal of 

 a palpable tumor in the region of the left kidney. It proved to be hyper- 

 nephroma of the left adrenal. The pituitary and pineal bodies were 

 normal macroscopically and microscopically. Jump, Beates and Babcock 

 record the case of a girl of seven years on whom axillary and pubic hair 

 appeared at the age of one year. At seven years she measured 53 inches 

 in length and weighed 90 Ibs. Growth of beard had appeared, and the 

 clitoris was enlarged. A tumor in the right hypochondriac region ap- 



