Nestler Ulf, Gräfe Daniel, Strehlow Vincent, Jauss Robin-Tobias, Merkenschlager Andreas, Schönfeld Annika, Wilhelmy Florian
Department of Neurosurgery, University Hospital, 04103 Leipzig, Germany.
Institute for Pediatric Radiology, University Hospital, 04103 Leipzig, Germany.
Clin Pract. 2025 Jan 20;15(1):22. doi: 10.3390/clinpract15010022.
: PTEN hamartoma tumor syndrome (PHTS) has evolved into an umbrella term for a range of syndromes, characterized by loss-of-function variants in the phosphatase and tensin homolog (PTEN) tumor suppressor gene on chromosome 10q23.31. This can result in a lifelong tumor predisposition in patients. Often, the syndrome is diagnosed in early childhood because of macrocephaly, dermatological findings, or development delay. Since the correlation between phenotype and genotype is weak, and the penetrance is age-dependent, this poses the question of the appropriate timing of potentially invasive and burdensome examinations for early cancer detection. : The present report describes an infant with cleft palate associated with PHTS, a rare occurrence, though the initial report of Cowden syndrome already pointed to oromaxillofacial abnormalities. The recent pediatric literature is reviewed to assess which clinical symptoms should raise suspicion of PHTS and may then lead to early genetic counseling. : Since the amount of prospective data remains limited, and the estimation of tumor risk during infancy and adulthood is very difficult, we advocate for early and broad genetic testing in suspected cases, to gain more insights into this rare disease and allow for better counseling for patients and their families.
PTEN错构瘤肿瘤综合征(PHTS)已演变成一系列综合征的统称,其特征是位于10q23.31染色体上的磷酸酶和张力蛋白同源物(PTEN)肿瘤抑制基因存在功能丧失变异。这可能导致患者终身有肿瘤易感性。通常,由于巨头畸形、皮肤病学表现或发育迟缓,该综合征在儿童早期被诊断出来。由于表型与基因型之间的相关性较弱,且外显率与年龄有关,这就引发了关于进行潜在侵入性和繁重检查以早期发现癌症的合适时机的问题。
本报告描述了一名患有腭裂并伴有PHTS的婴儿,这种情况较为罕见,尽管考登综合征的最初报告已指出口颌面异常。回顾近期的儿科文献,以评估哪些临床症状应引起对PHTS的怀疑,进而可能导致早期遗传咨询。
由于前瞻性数据仍然有限,且在婴儿期和成年期评估肿瘤风险非常困难,我们主张对疑似病例进行早期和广泛的基因检测,以更深入了解这种罕见疾病,并为患者及其家属提供更好的咨询。