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一名患有腭裂并与PTEN错构瘤肿瘤综合征相关的新生儿。

A Newborn with Cleft Palate Associated with PTEN Hamartoma Tumor Syndrome.

作者信息

Nestler Ulf, Gräfe Daniel, Strehlow Vincent, Jauss Robin-Tobias, Merkenschlager Andreas, Schönfeld Annika, Wilhelmy Florian

机构信息

Department of Neurosurgery, University Hospital, 04103 Leipzig, Germany.

Institute for Pediatric Radiology, University Hospital, 04103 Leipzig, Germany.

出版信息

Clin Pract. 2025 Jan 20;15(1):22. doi: 10.3390/clinpract15010022.

DOI:10.3390/clinpract15010022
PMID:39851805
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11764304/
Abstract

: 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.

摘要

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。

相似文献

1
A Newborn with Cleft Palate Associated with PTEN Hamartoma Tumor Syndrome.一名患有腭裂并与PTEN错构瘤肿瘤综合征相关的新生儿。
Clin Pract. 2025 Jan 20;15(1):22. doi: 10.3390/clinpract15010022.
2
PTEN Hamartoma tumor syndrome in childhood: A review of the clinical literature.儿童中的 PTEN 错构瘤肿瘤综合征:临床文献复习。
Am J Med Genet C Semin Med Genet. 2019 Dec;181(4):591-610. doi: 10.1002/ajmg.c.31743. Epub 2019 Oct 14.
3
SHH medulloblastoma and very early onset of bowel polyps in a child with hamartoma tumor syndrome.一名患有错构瘤肿瘤综合征的儿童出现SHH型髓母细胞瘤并很早发生肠息肉。
Front Mol Neurosci. 2023 Aug 24;16:1228389. doi: 10.3389/fnmol.2023.1228389. eCollection 2023.
4
Exploring the Prevalence of Oral Features for Early Detection of PTEN Hamartoma Tumour Syndrome.探讨口腔特征在早期检测 PTEN 错构瘤肿瘤综合征中的应用。
Int Dent J. 2024 Dec;74(6):1424-1431. doi: 10.1016/j.identj.2024.04.014. Epub 2024 May 1.
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The complexity of phosphatase and tensin homolog hamartoma tumor syndrome: A case report.磷酸酶与张力蛋白同源物错构瘤综合征的复杂性:一例报告
SAGE Open Med Case Rep. 2024 Apr 6;12:2050313X241245317. doi: 10.1177/2050313X241245317. eCollection 2024.
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Hamartoma Tumor Syndrome: A Clinical Overview.错构瘤综合征:临床概述
Cancers (Basel). 2019 Jun 18;11(6):844. doi: 10.3390/cancers11060844.
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Cutaneous lipomas and macrocephaly as early signs of PTEN hamartoma tumor syndrome.皮肤脂肪瘤和巨头畸形作为PTEN错构瘤肿瘤综合征的早期体征。
Pediatr Dermatol. 2020 Sep;37(5):839-843. doi: 10.1111/pde.14265. Epub 2020 Jul 13.
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Proteus-Like Syndrome: A Rare Phenotype of Phosphatase and Tensin Homolog Hamartoma Tumor Syndrome.类变形杆菌综合征:一种磷酸酶和张力蛋白同源物错构瘤肿瘤综合征的罕见表型。
Cureus. 2022 Apr 14;14(4):e24135. doi: 10.7759/cureus.24135. eCollection 2022 Apr.
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Genotype-phenotype associations in a large PTEN Hamartoma Tumor Syndrome (PHTS) patient cohort.大型PTEN错构瘤肿瘤综合征(PHTS)患者队列中的基因型-表型关联
Eur J Med Genet. 2022 Dec;65(12):104632. doi: 10.1016/j.ejmg.2022.104632. Epub 2022 Oct 18.
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Novel dermatological and skeletal features associated with PTEN variant in PTEN hamartoma tumor syndrome.PTEN 错构瘤综合征相关的新型皮肤和骨骼特征与 PTEN 变异有关。
Eur J Med Genet. 2023 Aug;66(8):104798. doi: 10.1016/j.ejmg.2023.104798. Epub 2023 Jun 10.

本文引用的文献

1
Imaging findings of children with PTEN-related hamartoma tumor syndrome: a 20-year multicentric pediatric cohort.PTEN 相关错构瘤综合征患儿的影像学表现:一项 20 年多中心儿科队列研究。
Pediatr Radiol. 2024 Jun;54(7):1116-1127. doi: 10.1007/s00247-024-05922-8. Epub 2024 Apr 22.
2
The complexity of phosphatase and tensin homolog hamartoma tumor syndrome: A case report.磷酸酶与张力蛋白同源物错构瘤综合征的复杂性:一例报告
SAGE Open Med Case Rep. 2024 Apr 6;12:2050313X241245317. doi: 10.1177/2050313X241245317. eCollection 2024.
3
PTEN hamartoma tumor syndrome: Clinical and genetic characterization in pediatric patients.
PTEN 错构瘤肿瘤综合征:儿科患者的临床和遗传特征。
Childs Nerv Syst. 2024 Jun;40(6):1689-1697. doi: 10.1007/s00381-024-06301-2. Epub 2024 Feb 26.
4
The PTEN hamartoma tumor syndrome: how oral clinicians may save lives.PTEN错构瘤肿瘤综合征:口腔临床医生如何挽救生命。
Clin Adv Periodontics. 2023 Mar;13(1):21-26. doi: 10.1002/cap.10196. Epub 2022 Apr 18.
5
Neuroblastoma and cutaneous angiosarcoma in a child with PTEN hamartoma tumor syndrome.一名患有PTEN错构瘤肿瘤综合征的儿童同时患神经母细胞瘤和皮肤血管肉瘤。
Pediatr Blood Cancer. 2022 Oct;69(10):e29656. doi: 10.1002/pbc.29656. Epub 2022 Mar 12.
6
Distinct metabolic profiles associated with autism spectrum disorder versus cancer in individuals with germline PTEN mutations.在携带种系PTEN突变的个体中,与自闭症谱系障碍和癌症相关的不同代谢谱。
NPJ Genom Med. 2022 Mar 3;7(1):16. doi: 10.1038/s41525-022-00289-x.
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Revisiting the embryogenesis of lip and palate development.重新审视唇腭裂发育的胚胎发生过程。
Oral Dis. 2022 Jul;28(5):1306-1326. doi: 10.1111/odi.14174. Epub 2022 Mar 5.
8
PTEN hamartoma tumor syndrome in childhood and adolescence-a comprehensive review and presentation of the German pediatric guideline.儿童和青少年期的PTEN错构瘤肿瘤综合征——德国儿科指南的全面综述与介绍
Mol Cell Pediatr. 2022 Feb 21;9(1):3. doi: 10.1186/s40348-022-00135-1.
9
Cerebral MRI and Clinical Findings in Children with Hamartoma Tumor Syndrome: Can Cerebral MRI Scan Help to Establish an Earlier Diagnosis of PHTS in Children?脑 MRI 与脑颜面血管瘤病综合征患儿的临床表现:脑 MRI 扫描有助于早期诊断脑颜面血管瘤病综合征吗?
Cells. 2020 Jul 10;9(7):1668. doi: 10.3390/cells9071668.
10
Cutaneous lipomas and macrocephaly as early signs of PTEN hamartoma tumor syndrome.皮肤脂肪瘤和巨头畸形作为PTEN错构瘤肿瘤综合征的早期体征。
Pediatr Dermatol. 2020 Sep;37(5):839-843. doi: 10.1111/pde.14265. Epub 2020 Jul 13.