In Case 1, reported above, the patient menstruated regularly for five years after the removal of the first tumor, but had no menstrual flow for two years prior to her last visit to me. In Case 2 the menses were normal. In Case 3 there was some menorrhagia. I am inclined to attribute this symptom in this case, however, to the twist in the pedicle. I think we are warranted in concluding that either amenorrhea or menorrhagia is much more common in malignant tumors of the ovary than in benign

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... of the ovary, and that both forms of irregularity are equally indicative of malignancy. In my former paper I quote Wermuth as saying that sarcoma in the young may cause premature signs of puberty, and added that I had not been able to find any other author who con¬ firmed this statement, and that it seemed to me prob¬ lematic. Since that time I have run across a report of the following case by Verebely4 : A girl, 6 years old, up to 5 years of age had developed normally. Since a year hemorrhages had recurred monthly and other signs of puberty had appeared. The child was about 4 inches taller than one of corresponJing age, and the breasts, which were "the size of lemons, contained glandular structure. In the axillae, as well as the pubic regions, there was an abundant growth of hair. The labia were thick and pigmented and the vagina of abnormal size. Examina¬ tion of the abdomen revealed a nodular tumor of the size of a child's head connected with the left side of the uterus. At the operation a very vascular ovarian sarcoma was found. The uterus was of the size of that of an 18 or 19 year old girl, the right ovary being normal.