Adrenal cortical hyperfunction in childhood; report of a case with adrenocortical hyperplasia and testicular adrenal rests.

An additional case of adrenal cortical hyperfunction occurring in a boy aged 3 8/12 years is reported. The clinical features included bulimia, obesity, hypertension, hirsutism, personality change, osteoporosis and intermittent neurologic manifestations. The urinary excretion of 17-ketosteroids and corticoids was increased. There was no genital dystrophy or impairment of glucose tolerance. Marked temporary improvement followed partial bilateral resection of the enlarged adrenals. The patient died 10 months after operation, following exposure to epidemic parotitis, as a result of massive hemorrhage from ulceration of the esophagus. Necropsy showed bilateral nodular adrenal cortical hyperplasia limited to the fascicular and reticular zones. Bilateral rests of adrenocortical cells were found in the rete testis. No Crooke9s changes or adenomata were found in the basophile cells of the anterior pituitary.