(Reprinted from “ Pacific Medical Journal,” September, 1893.) 
SYMMETRICAL LOCALIZED HYPERPLASIAS OF THE 
SUBCUTANEOUS FAT. / 
By ALBERT S. ADLER, M. D. 
(Presented before the 8. F. f.erinan Medical Society, June 6th, 1893.) 
The patient, David Basker, is a mulatto, weighing 225 pounds, 
and 5 feet four inches in height, fifty-three years, and was 2 
Symmetrical Localized Hyperplasias of the Subcutaneous Fat. 
born in Maryland. None of the other Baskeridae seem to have 
been afflicted with either fatty or any other kind of tumors as 
far as can be ascertained at present. 
His mother has borne in all sixteen children, all of whom are 
still alive and well. He has never suffered from any severe ill- 
ness but syphilis, which he acquired twenty-three years ago. 
He is now married and has two boys, one eighteen and the other 
twelve years of age, and they both are healthy. 
About seven years ago he first noticed swellings in the groins 
and afterwards on the front of the chest. Two years ago Symmetrical Localized Hyperplasias of the Subcutaneous Fat. 
3 
the tumefactions on the back and under the chin became no- 
ticeable. 
There are now the following enlargements plainly demon- 
strable: An enormous growth, about the size of a milt, on 
the back of the neck in the middle line; two smaller bi-later- 
ally symmetrical tumors in the occipital region; another in the 
middle line in the front under the chin forming an immense 
dewlap and extending up into both parotid regions; one neo- 
plasm in each groin, absolutely symmetrical, and projecting 
away out as two well rounded masses, and causing the penis 
“ to hide its diminished head ” between them. 
The fatty deposits on the upper arms and on the forearms are 
more diffuse than on the rest of the body. The left upper arm 
measures twenty and a half inches around its middle, and the 
right nineteen and one-quarter inches. The left forearm meas- 
ures fourteen inches around its upper part, and the right thir- 
teen and one-half inches. 
He measures thirty-nine inches around the waist—not a large 
measurement for a man of his build—but around the hips, over 
the tumors described above as being situated in the groins, the 
the measurement is forty-four inches. 
There is one deep unilateral tumor over the left rectus muscle 
above the level of the navel. The dugs hang down like those of 
a fleshy woman. 
The measurement around the neck, including the median 
tumor in the posterior cervical region, is twenty-three inches 
and a quarter. From the apex of the pinna of one ear, around 
the large mass under the chin to the apex of the pinna of the 
opposite ear, is eighteen inches, and from the lower lip to the 
inferior border of this same mass is four inches. 
The skin all over these growths is perfectly normal, some- 
what tense and easily movable, and those of the growths which 
are circumscribed are movable on the subjacent structures. The 
tumors are not painful.