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[儿童期的戈林综合征]

[Gorlin syndrome in the paediatric age].

作者信息

Roncalés-Samanes P, Peña-Segura J L, Fernando-Martínez R, Fuertes-Rodrigo C, García-Oguiza A, López-Pisón J

机构信息

HUMS. Hospital Universitario Miguel Servet, 50009 Zaragoza, Espana.

出版信息

Rev Neurol. 2014 Apr 1;58(7):303-7.

Abstract

INTRODUCTION

Gorlin syndrome (GS) is a disorder transmitted by dominant autosomal inheritance associated to mutations in PTCH1, the main characteristic of which is the appearance of basal cell carcinomas, together with skeletal abnormalities, odontogenic keratocysts and intracranial tumours.

CASE REPORT

A girl aged 3 years and 10 months, who was admitted due to acute ataxia. Some of the more striking features in the patient's personal history include psychomotor retardation and a family history of suspected GS in the mother as a result of a maxillary cyst. An examination revealed macrocephaly with a prominent forehead and hypertelorism, as well as nevus. A genetic study for GS was requested, in which mutation c.930delC was detected in exon 6 of the PTCH1 gene in heterozygosis.

CONCLUSIONS

In GS there is an increase in the likelihood of developing basal cell carcinomas and strict dermatological monitoring is necessary. A clinical neurological follow-up and also magnetic resonance imaging scans are needed for an early diagnosis of intracranial tumours, especially in the case of medulloblastomas. Odontogenic keratocysts, other skin disorders, and cardiac and ovarian fibromas are characteristic, as are skeletal abnormalities, which require regular clinical and neuroimaging controls and treatment if needed, but radiation must be avoided. GS is a rare disorder, but it must be suspected in the presence of characteristic alterations. It requires a multidisciplinary follow-up, and it is also necessary to establish a protocol on how to act so as to allow early diagnosis and treatment of the potentially severe complications deriving from this disease.

摘要

引言

戈林综合征(GS)是一种常染色体显性遗传疾病,与PTCH1基因突变相关,其主要特征是基底细胞癌的出现,同时伴有骨骼异常、牙源性角化囊肿和颅内肿瘤。

病例报告

一名3岁10个月大的女孩因急性共济失调入院。患者个人病史中一些较为显著的特征包括精神运动发育迟缓,其母亲因上颌囊肿有疑似GS的家族病史。检查发现巨头畸形,前额突出,眼距增宽,以及痣。进行了GS的基因研究,结果在PTCH1基因第6外显子中检测到杂合子c.930delC突变。

结论

在GS患者中,发生基底细胞癌的可能性增加,因此需要严格的皮肤科监测。对于颅内肿瘤,尤其是髓母细胞瘤,需要进行临床神经学随访以及磁共振成像扫描以早期诊断。牙源性角化囊肿、其他皮肤疾病以及心脏和卵巢纤维瘤是其特征表现,骨骼异常也是如此,这需要定期的临床和神经影像学检查,并在需要时进行治疗,但必须避免放疗。GS是一种罕见疾病,但在出现特征性改变时必须予以怀疑。它需要多学科随访,还需要制定一套行动方案,以便能够早期诊断和治疗由该疾病引发的潜在严重并发症。

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