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单纯性施万细胞瘤病还是不完全型科芬-西里斯综合征?一例特殊病例报告。

Simple schwannomatosis or an incomplete Coffin-Siris? Report of a particular case.

作者信息

Bellantoni G, Guerrini F, Del Maestro M, Galzio R, Luzzi S

机构信息

Unit of Neurosurgery, Department of Clinical Surgical Diagnostic and Pediatric Sciences, University of Pavia, Italy.

Department of Emergency and Organ Transplantation, University "Aldo Moro", Bari, Italy.

出版信息

eNeurologicalSci. 2018 Nov 27;14:31-33. doi: 10.1016/j.ensci.2018.11.021. eCollection 2019 Mar.

Abstract

BACKGROUND

Schwannomatosis is a genetic disorder that belongs to NF family. The mutation of SMARCB1 gene has been related to this entity and Coffin-Siris syndrome, as well. We reported a case of a female patient with SMARCB1 mutation who has developed a spontaneuous spleen rupture.

CASE DESCRIPTION

A 28 years old female patient with a story of a Sjogren syndrome, celiac disease and a surgically treated schwannoma, presented to our observation in July 2013 for a pain on the left elbow, where a tumefation was present. After neuroradiological evaluations, a surgical resection was performed and a schwannoma was diagnosed. Genetic exams revealed a puntiform SMARCB1 gene mutation. During 2015, she was subdued to the removal of an another schwannoma located into the cervical medullary canal. Few months later, she was operated in an another hospital for a spontaneous spleen rupture in a possible context of wandering spleen.

CONCLUSION

We think that the patient could suffer from a partially expressed Coffin-Siris syndrome. No cases of spontaneous rupture in a context of wandering spleen have been ever described as for as schwannomatosis or Coffin-Siris syndrome are concerned. More cases are necessary to establish a direct relationship.

摘要

背景

神经鞘瘤病是一种属于神经纤维瘤病家族的遗传性疾病。SMARCB1基因突变与该疾病以及科芬-西里斯综合征均有关联。我们报告了一例携带SMARCB1基因突变的女性患者,该患者发生了自发性脾破裂。

病例描述

一名28岁女性患者,有干燥综合征、乳糜泻病史,曾接受过手术治疗的神经鞘瘤。2013年7月,因左肘部疼痛并伴有肿块前来我院就诊。经神经放射学评估后,进行了手术切除,诊断为神经鞘瘤。基因检测发现点状SMARCB1基因突变。2015年,她接受了位于颈髓管内的另一例神经鞘瘤切除术。几个月后,她在另一家医院因游走脾可能导致的自发性脾破裂接受了手术。

结论

我们认为该患者可能患有部分表现型的科芬-西里斯综合征。就神经鞘瘤病或科芬-西里斯综合征而言,从未有过游走脾导致自发性破裂的病例描述。需要更多病例来建立直接关联。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1676/6277249/1a05eadd4686/gr1.jpg

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