Portaro Simona, Naro Antonino, Guarneri Claudio, Di Toro Giuseppe, Manuli Alfredo, Calabrò Rocco Salvatore
Istituto di Ricovero e Cura a Carattere Scientifico Centro Neurolesi "Bonino-Pulejo".
Department of Clinical and Experimental Medicine - Section of Dermatology, University of Messina, Messina.
Medicine (Baltimore). 2018 Nov;97(48):e13448. doi: 10.1097/MD.0000000000013448.
Myotonic dystrophy type 1 (DM1) is an autosomal dominant disease caused by a cytosine, guanine, thymine (CTG) trinucleotide repeat expansion in the non-coding region of dystrophia myotonica protein kinase gene, causing a multisystem involvement. To date, few studies have been performed to evaluate skin features in DM1 patients, but none reported on the possible association between the disease and tongue hemangiomas.
We report a case of a 63-year-old woman affected by DM1 and presenting, at the intraoral examination, several swelling and buish lesions occurring on buccal and palatal mucosa, and in the anterior two-thirds and margins of the tongue.
Multiple tongue hemangiomas in DM1 patient.
Color Doppler ultrasound revealed hypoechoic lesions with intermittent color picking suggestive of vascular lesion. Surgical excision was performed under general anesthesia. Histopathological examination was compatible with the diagnosis of cavernous hemangiomas.
At 6 months follow-up, a part from the cosmetic deformity, patient's hemangiomas did not bleed, but caused functional problems with speaking, mastication, and deglutition, in addition to the same symptoms induced by DM1.
This case may add new details to better characterize the DM1 phenotype, suggesting that even tongue hemangiomas may be part of the DM1 multisystem involvement.
1型强直性肌营养不良症(DM1)是一种常染色体显性疾病,由肌强直性营养不良蛋白激酶基因非编码区的胞嘧啶、鸟嘌呤、胸腺嘧啶(CTG)三核苷酸重复序列扩增引起,导致多系统受累。迄今为止,很少有研究评估DM1患者的皮肤特征,但尚无关于该疾病与舌部血管瘤之间可能关联的报道。
我们报告了一例63岁受DM1影响的女性病例,在口腔检查中发现颊黏膜、腭黏膜以及舌前三分之二和边缘出现多处肿胀和蓝色病变。
DM1患者的多发性舌部血管瘤。
彩色多普勒超声显示低回声病变,间歇性彩色信号提示血管病变。在全身麻醉下进行手术切除。组织病理学检查结果与海绵状血管瘤的诊断相符。
在6个月的随访中,除了美容畸形外,患者的血管瘤未出血,但除了DM1引起的相同症状外,还导致了说话、咀嚼和吞咽方面的功能问题。
该病例可能为更好地描述DM1表型增添新细节,表明即使舌部血管瘤也可能是DM1多系统受累的一部分。