CONGENITAL ADRENOCORTICAL HYPERPLASIA ASSOCIATED WITH HYPERPLASIA OF ABERRANT (INTRATESTICULAR) ADRENAL TISSUE*

Abstract
WILKINS (1) has had personal experience with 67 cases of virilizing adrenocortical hyperplasia, 50 in females and 17 in males. Testicular nodules were observed in at least 9 of these cases. In a few the nodule produced enlargement which was detectable clinically, but in most the nodule was first observed at autopsy. It is the purpose of this communication to describe a case of the adrenogenital syndrome produced by congenital adrenocortical hyperplasia with testicular involvement, and to discuss the nature of the lesion found in the testes. CASE REPORT The patient was a 2½-year-old boy, who had been born at the New Britain General Hospital on July 23, 1952, about four weeks before the expected date of delivery. The mother was a white woman whose blood group was Rh negative. At birth the infant's body weight was 5 pounds, 8 ounces. His blood group was B, Rh positive. The hemoglobin level was 15.4 Gm. per 100 cc, and the red blood cell count was 4.6 million per cu. mm. The red cells exhibited polychromasia and macrocytosis, and there were 1.0 erythroblasts and 10 normoblasts per 100 white cells. The white cell count was normal. Shortly after birth, the infant was given 140 cc. of blood intravenously and later the blood picture became normal. Since birth the child had had difficulty in feeding, and vomited frequently. Because of vomiting and failure to gain weight, he was transferred to another hospital where a diagnosis of adrenal insufficiency was made.