Absence of Pituitary Failure in Fat Boys with Testicular Deficiency

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The term Fröhlich’s syndrome is commonly used to designate obesity and retarded sexual maturation without regard for the fact that the original description of the condition by Babinski1 and by Fröhlich2,3 included also the presence of a suprasellar tumor. While obesity and retarded maturation are a combination frequently seen, suprasellar tumor is a rare concomitant. Adiposogenital dystrophy, a term proposed by Bartels,4 might be used appropriately for these more common cases without tumor were it not that it, too, was originally designed to include the presence of a suprasellar tumor.

Early workers4,5,6 pointed out that obesity could not result from pituitary failure. This fact has been repeatedly confirmed. Bailey and Bremer7 were the first to prove experimentally that a condition simulating adiposogenital dystrophy could be caused by a lesion in the hypothalamus alone, without injury to the pituitary gland. Substantiation of this concept has been abundant.8 The implication has remained, however, that the lack of pituitary gonadotrophins is the explanation of the gonadal deficiency in patients who are usually designated as having adiposogenital dystrophy. In cases of tumor in the region of the pituitary gland this supposition is undoubtedly true. Suprasellar tumors in boys are uncommon. When such a tumor occurs, it is likely to be associated with normal or less than normal height. The genitalia may be relatively infantile, but such patients are seldom obese.

Fröhlich’s patient was approximately 58 inches (145 cm.) in height according to Bruch’s estimate3 (no definite height was originally given) and was 118.8 pounds. . .



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