| Summary: | <p>Abstract</p> <p>Background</p> <p>Small supernumerary marker chromosomes (sSMC) are present ~2.6 × 10<sup>6 </sup>human worldwide. sSMC are a heterogeneous group of derivative chromosomes concerning their clinical consequences as well as their chromosomal origin and shape. Besides the sSMC present in Emanuel syndrome, i.e. der(22)t(11;22)(q23;q11), only few so-called complex sSMC are reported.</p> <p>Results</p> <p>Here we report three new cases of unique complex sSMC. One was a <it>de novo </it>case with a dic(13 or 21;22) and two were maternally derived: a der(18)t(8;18) and a der(13 or 21)t(13 or 21;18). Thus, in summary, now 22 cases of unique complex sSMC are available in the literature. However, this special kind of sSMC might be under-diagnosed among sSMC-carriers.</p> <p>Conclusion</p> <p>More comprehensive characterization of sSMC and approaches like reverse fluorescence in situ hybridization (FISH) or array based comparative genomic hybridization (array-CGH) might identify them to be more frequent than only ~0.9% among all sSMC.</p>
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