Nevoid basal cell carcinoma syndrome (Gorlin syndrome)

<p>Abstract</p> <p>Nevoid basal cell carcinoma syndrome (NBCCS), also known as Gorlin syndrome, is a hereditary condition characterized by a wide range of developmental abnormalities and a predisposition to neoplasms.</p> <p>The estimated prevalence varies from 1/57,000...

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Main Author: Lo Muzio Lorenzo
Format: Article
Language:English
Published: BMC 2008-11-01
Series:Orphanet Journal of Rare Diseases
Online Access:http://www.ojrd.com/content/3/1/32
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author Lo Muzio Lorenzo
author_facet Lo Muzio Lorenzo
author_sort Lo Muzio Lorenzo
collection DOAJ
description <p>Abstract</p> <p>Nevoid basal cell carcinoma syndrome (NBCCS), also known as Gorlin syndrome, is a hereditary condition characterized by a wide range of developmental abnormalities and a predisposition to neoplasms.</p> <p>The estimated prevalence varies from 1/57,000 to 1/256,000, with a male-to-female ratio of 1:1.</p> <p>Main clinical manifestations include multiple basal cell carcinomas (BCCs), odontogenic keratocysts of the jaws, hyperkeratosis of palms and soles, skeletal abnormalities, intracranial ectopic calcifications, and facial dysmorphism (macrocephaly, cleft lip/palate and severe eye anomalies). Intellectual deficit is present in up to 5% of cases. BCCs (varying clinically from flesh-colored papules to ulcerating plaques and in diameter from 1 to 10 mm) are most commonly located on the face, back and chest. The number of BBCs varies from a few to several thousand. Recurrent jaw cysts occur in 90% of patients. Skeletal abnormalities (affecting the shape of the ribs, vertebral column bones, and the skull) are frequent. Ocular, genitourinary and cardiovascular disorders may occur. About 5–10% of NBCCS patients develop the brain malignancy medulloblastoma, which may be a potential cause of early death.</p> <p>NBCCS is caused by mutations in the <it>PTCH1 </it>gene and is transmitted as an autosomal dominant trait with complete penetrance and variable expressivity.</p> <p>Clinical diagnosis relies on specific criteria. Gene mutation analysis confirms the diagnosis. Genetic counseling is mandatory. Antenatal diagnosis is feasible by means of ultrasound scans and analysis of DNA extracted from fetal cells (obtained by amniocentesis or chorionic villus sampling). Main differential diagnoses include Bazex syndrome, trichoepithelioma papulosum multiplex and Torre's syndrome (Muir-Torre's syndrome).</p> <p>Management requires a multidisciplinary approach. Keratocysts are treated by surgical removal. Surgery for BBCs is indicated when the number of lesions is limited; other treatments include laser ablation, photodynamic therapy and topical chemotherapy. Radiotherapy should be avoided. Vitamin A analogs may play a preventive role against development of new BCCs.</p> <p>Life expectancy in NBCCS is not significantly altered but morbidity from complications can be substantial. Regular follow-up by a multi-specialist team (dermatologist, neurologist and odontologist) should be offered. Patients with NBCCS should strictly avoid an excessive sun exposure.</p>
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spelling doaj.art-4a7e38e7684f45f0978ff5ca5a9209c92022-12-21T21:55:11ZengBMCOrphanet Journal of Rare Diseases1750-11722008-11-01313210.1186/1750-1172-3-32Nevoid basal cell carcinoma syndrome (Gorlin syndrome)Lo Muzio Lorenzo<p>Abstract</p> <p>Nevoid basal cell carcinoma syndrome (NBCCS), also known as Gorlin syndrome, is a hereditary condition characterized by a wide range of developmental abnormalities and a predisposition to neoplasms.</p> <p>The estimated prevalence varies from 1/57,000 to 1/256,000, with a male-to-female ratio of 1:1.</p> <p>Main clinical manifestations include multiple basal cell carcinomas (BCCs), odontogenic keratocysts of the jaws, hyperkeratosis of palms and soles, skeletal abnormalities, intracranial ectopic calcifications, and facial dysmorphism (macrocephaly, cleft lip/palate and severe eye anomalies). Intellectual deficit is present in up to 5% of cases. BCCs (varying clinically from flesh-colored papules to ulcerating plaques and in diameter from 1 to 10 mm) are most commonly located on the face, back and chest. The number of BBCs varies from a few to several thousand. Recurrent jaw cysts occur in 90% of patients. Skeletal abnormalities (affecting the shape of the ribs, vertebral column bones, and the skull) are frequent. Ocular, genitourinary and cardiovascular disorders may occur. About 5–10% of NBCCS patients develop the brain malignancy medulloblastoma, which may be a potential cause of early death.</p> <p>NBCCS is caused by mutations in the <it>PTCH1 </it>gene and is transmitted as an autosomal dominant trait with complete penetrance and variable expressivity.</p> <p>Clinical diagnosis relies on specific criteria. Gene mutation analysis confirms the diagnosis. Genetic counseling is mandatory. Antenatal diagnosis is feasible by means of ultrasound scans and analysis of DNA extracted from fetal cells (obtained by amniocentesis or chorionic villus sampling). Main differential diagnoses include Bazex syndrome, trichoepithelioma papulosum multiplex and Torre's syndrome (Muir-Torre's syndrome).</p> <p>Management requires a multidisciplinary approach. Keratocysts are treated by surgical removal. Surgery for BBCs is indicated when the number of lesions is limited; other treatments include laser ablation, photodynamic therapy and topical chemotherapy. Radiotherapy should be avoided. Vitamin A analogs may play a preventive role against development of new BCCs.</p> <p>Life expectancy in NBCCS is not significantly altered but morbidity from complications can be substantial. Regular follow-up by a multi-specialist team (dermatologist, neurologist and odontologist) should be offered. Patients with NBCCS should strictly avoid an excessive sun exposure.</p>http://www.ojrd.com/content/3/1/32
spellingShingle Lo Muzio Lorenzo
Nevoid basal cell carcinoma syndrome (Gorlin syndrome)
Orphanet Journal of Rare Diseases
title Nevoid basal cell carcinoma syndrome (Gorlin syndrome)
title_full Nevoid basal cell carcinoma syndrome (Gorlin syndrome)
title_fullStr Nevoid basal cell carcinoma syndrome (Gorlin syndrome)
title_full_unstemmed Nevoid basal cell carcinoma syndrome (Gorlin syndrome)
title_short Nevoid basal cell carcinoma syndrome (Gorlin syndrome)
title_sort nevoid basal cell carcinoma syndrome gorlin syndrome
url http://www.ojrd.com/content/3/1/32
work_keys_str_mv AT lomuziolorenzo nevoidbasalcellcarcinomasyndromegorlinsyndrome