Sexual Infantilism With Optic Atrophy in Cases of Tumor Affecting the Hypophysis Cerebri.

A disturbance of menstrual function may be one of the earliest symptoms of a certain class of intracranial tumors.Particular attention has recently been called to this fact by Axenfeld and Yamaguchi, by von Abelsdorf and by Muller.Growths in most diverse situations, or, indeed, an increase of intracranial tension from conditions non-neoplastic, have been known to affect the regularity, or even to completely interrupt for long periods, pre¬ viously normal catamenia.In the personal records of about sixty cases of brain tumor, the majority of which have come under my care in Dr. Halsted's service during the past five years, a history of menstrual disturbance has been recorded in several instances.The physiological explanation of this symptom can only be conjectured, but it seems quite possible that in some way it is due to an interference with the normal activity of the pituit¬ ary gland.The cases may be divided into two groups: One, those in which amenorrhea accompanies tumors arising from the hypo¬ physis or affecting the gland by direct compression; the other, those in which menstrual disturbance is a symptom of tumors situated elsewhere.In the latter group Muller has suggested that an internal hydrocephalus, through distension of the recessus infundibuli, may interfere with the function of the gland.There is, however, no certain proof of this.In the former group -those with tumors in the hypophyseal region-the relation of sexual development and menstrual activity to the condition of the pituitary gland is more clear.I shall limit myself to the consideration of lesions of this type; and inasmuch as the two patients, whose histories I shall report have been women, I shall not consider the effect of similar lesions on the male, although in