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Baeza-Pagador A, Tejero-Martínez A, Salom-Alonso L, Camañes-Gonzalvo S, García-Sanz V, Paredes-Gallardo V. Diagnostic Methods for the Prenatal Detection of Cleft Lip and Palate: A Systematic Review. J Clin Med 2024; 13:2090. [PMID: 38610855 PMCID: PMC11012824 DOI: 10.3390/jcm13072090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Revised: 03/03/2024] [Accepted: 03/08/2024] [Indexed: 04/14/2024] Open
Abstract
Background: Accurate prenatal diagnosis of cleft lip and palate is essential to discuss severity prediction, perform appropriate parental counseling, and, at last, establish long-term treatment planning. The aim of this systematic review was to analyze the accuracy of various imaging techniques for the prenatal diagnosis of cleft lip and palate, assess the pregnancy phase for orofacial clefts diagnosis, and study the different cleft types in terms of diagnostic methods, timing, and predictability. Methods: A search of the PubMed, EMBASE, Scopus, and Web of Science databases was conducted to identify potentially relevant studies published until January 2024. The quality of the selected articles was assessed using the Newcastle-Ottawa scale for methodological quality assessment of cohort studies and the QUADAS-2 scale for diagnostic test studies. Results: A total of 18 studies met the eligibility criteria and were included in the review. The findings of this review indicate that the majority of studies showed improved diagnostic accuracy when supplementary techniques, such as 3D ultrasound or magnetic resonance imaging, were added to 2D ultrasound. Conclusions: The implementation of magnetic resonance imaging as a standard procedure could significantly improve the precision of diagnosing cleft lip and palate. Therefore, the diagnostic technique used will play a crucial role in the accuracy of the diagnosis.
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Affiliation(s)
- Ana Baeza-Pagador
- Orthodontics Teaching Unit, Department of Stomatology, Faculty of Medicine and Dentistry, University of Valencia, 46010 Valencia, Spain; (A.B.-P.); (A.T.-M.); (S.C.-G.); (V.G.-S.)
| | - Ana Tejero-Martínez
- Orthodontics Teaching Unit, Department of Stomatology, Faculty of Medicine and Dentistry, University of Valencia, 46010 Valencia, Spain; (A.B.-P.); (A.T.-M.); (S.C.-G.); (V.G.-S.)
| | - Lucas Salom-Alonso
- Department of Maxillofacial Surgery, La Fe Hospital, 46026 Valencia, Spain;
| | - Sara Camañes-Gonzalvo
- Orthodontics Teaching Unit, Department of Stomatology, Faculty of Medicine and Dentistry, University of Valencia, 46010 Valencia, Spain; (A.B.-P.); (A.T.-M.); (S.C.-G.); (V.G.-S.)
| | - Verónica García-Sanz
- Orthodontics Teaching Unit, Department of Stomatology, Faculty of Medicine and Dentistry, University of Valencia, 46010 Valencia, Spain; (A.B.-P.); (A.T.-M.); (S.C.-G.); (V.G.-S.)
| | - Vanessa Paredes-Gallardo
- Orthodontics Teaching Unit, Department of Stomatology, Faculty of Medicine and Dentistry, University of Valencia, 46010 Valencia, Spain; (A.B.-P.); (A.T.-M.); (S.C.-G.); (V.G.-S.)
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Lü Y, Jiang Y, Wu H, Qi Q, Zhou X, Guo Q, Hao N, Liu J, Meng H. Prenatal genetic diagnosis of disseminated infantile myofibromatosis: a case report and literature review. BMC Med Genomics 2023; 16:185. [PMID: 37568122 PMCID: PMC10416477 DOI: 10.1186/s12920-023-01612-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 07/17/2023] [Indexed: 08/13/2023] Open
Abstract
BACKGROUND Infantile myofibromatosis (IM) is a rare disorder characterized by the formation of nodules in the skin, muscle, bone, and, more rarely, visceral organs. Very few cases are detected prenatally, and the final diagnosis cannot be made until pathology is completed after birth. Here, we present a case of disseminated form IM (DFIM) with a diagnosis established on prenatal genetic grounds. CASE PRESENTATION A woman at 23 weeks of gestation was referred for ultrasound evaluation of fetal kidney abnormality. Generalized masses in the skin and muscle of the fetus developed at 28 weeks. Prenatal genetic testing identified the pathogenic heterozygous variant c.1681C > T (p.R561C) of the PDGFRB gene inherited from the asymptomatic father. Intrauterine demise occurred at 31 weeks. Autopsy confirmed DFIM with involvement of the heart and kidney. All cases of prenatally detected IM were reviewed, revealing an association of high mortality with DFIM. CONCLUSIONS Prenatal IM diagnosis is difficult. Initial detection is always based on ultrasound. DFIM has high mortality. The germline p.R561C mutation in PDGFRB may cause fetal demise due to severe visceral involvement of IM. Prenatal genetic testing provides a diagnosis before pathological results are available, leading to better counseling and management of pregnancy with a fetus with IM.
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Affiliation(s)
- Yan Lü
- Department of Obstetrics and Gynecology, National Clinical Research Center for Obstetric & Gynecologic Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Beijing, China
| | - Yulin Jiang
- Department of Obstetrics and Gynecology, National Clinical Research Center for Obstetric & Gynecologic Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Beijing, China
| | - Huanwen Wu
- Department of Pathology, Peking Union Medical College Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Beijing, China
| | - Qingwei Qi
- Department of Obstetrics and Gynecology, National Clinical Research Center for Obstetric & Gynecologic Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Beijing, China
| | - Xiya Zhou
- Department of Obstetrics and Gynecology, National Clinical Research Center for Obstetric & Gynecologic Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Beijing, China
| | - Qi Guo
- Department of Obstetrics and Gynecology, National Clinical Research Center for Obstetric & Gynecologic Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Beijing, China
| | - Na Hao
- Department of Obstetrics and Gynecology, National Clinical Research Center for Obstetric & Gynecologic Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Beijing, China
| | - Juntao Liu
- Department of Obstetrics and Gynecology, National Clinical Research Center for Obstetric & Gynecologic Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Beijing, China.
| | - Hua Meng
- Department of Ultrasound, Peking Union Medical College Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Beijing, China.
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Diagnostic Value and Application of Prenatal MRI and Ultrasound in Fetal Cleft Lip and Palate. CONTRAST MEDIA & MOLECULAR IMAGING 2022; 2022:9410161. [PMID: 35655725 PMCID: PMC9132648 DOI: 10.1155/2022/9410161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Accepted: 04/23/2022] [Indexed: 11/30/2022]
Abstract
Objective The purpose was to explore the diagnostic value and application of prenatal magnetic resonance imaging (MRI) and ultrasound (US) in fetal cleft lip and palate. Methods From January 2018 to December 2019, 39 pregnant women without normal fetal maxillofacial structure or with fetal maxillofacial deformity under US examination in our hospital were selected as the study subjects. Not knowing the clinical data of the pregnant women, MRI and US physicians performed diagnostic analysis on the MRI or US images of all the study subjects and analyzed the results of prenatal MRI and US diagnosis and postpartum follow-up to compare the diagnostic efficacy and confidence of MRI and US. Results The follow-up found that there were 20 cases of cleft lip, 15 cases of cheilopalatognathus, 3 cases of cleft palate, and 1 case of unilateral cleft lip with alveolar cleft, with a total of 39 cases having cleft lip and palate deformity. MRI and US had the same efficacy in the diagnosis of cleft lip. As for cleft palates, the diagnostic accuracy of MRI (94.87%) was significantly better than that of US (48.72%, P < 0.001). The diagnostic confidence of fetal cleft lip and palate by MRI (89.73%) was significantly better than that of US (43.59%, P < 0.001). The AUC of US (0.597) was significantly less than that of MRI (0.940), indicating that the diagnostic accuracy of US was not as good as that of MRI (P < 0.05). The sensitivity and 1 − specificity of MRI were significantly higher than those of US. Conclusion MRI is more accurate than US in the diagnosis of fetal cleft lip and palate, and MRI can be the preferred method for prenatal detection of cleft lip and palate, thus providing more accurate opinions and information for perinatal pregnant women.
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Popa Ș, Apostol D, Bîcă O, Benchia D, Sârbu I, Ciongradi CI. Prenatally Diagnosed Infantile Myofibroma of Sartorius Muscle-A Differential for Soft Tissue Masses in Early Infancy. Diagnostics (Basel) 2021; 11:2389. [PMID: 34943624 PMCID: PMC8700622 DOI: 10.3390/diagnostics11122389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 12/09/2021] [Accepted: 12/11/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Infantile myofibromatosis (IM) is a soft tissue disease with solitary or multiple benign tumors, and an etiology still unknown. IM is a mesenchymal disorder of early infancy and is more frequent in males. IM may present as a solitary lesion of the skin, bone, muscle, subcutaneous tissue, located at the head, neck, and trunk, with good prognosis; or, as a multicentric form, with or without visceral involvement (heart, lung, gastrointestinal tract, kidney), with a poor prognosis. The definitive diagnosis of IM is confirmed by pathology. Treatment may be conservative, surgical, or chemotherapeutical. CASE PRESENTATION A two months old female patient, prenatally diagnosed at 30 weeks, presenting with a tumor on the antero-internal aspect of the left thigh. She was admitted due to rapid postnatal evolution, and the patient required surgery for tumor resection. Previously, clinically, biological and imaging investigations were performed, but the final diagnosis was histological and by immunostaining. The patient had a favorable postoperative outcome. CONCLUSIONS Despite its low frequency, IM should be considered in the differential diagnosis of soft tissue masses at an early age. The clinical form (solitary or multicentric), location, and visceral involvement will dictate the treatment and prognosis.
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Affiliation(s)
- Ștefan Popa
- 3rd Department of Medical Specialities–Legal Medicine, “Grigore T. Popa” University of Medicine and Pharmacy Iași, 700115 Iași, Romania;
- “Sfânta Maria” Emergency Children Hospital Iași, 700309 Iași, Romania; (D.A.); (O.B.); (D.B.); (C.I.C.)
| | - Dan Apostol
- “Sfânta Maria” Emergency Children Hospital Iași, 700309 Iași, Romania; (D.A.); (O.B.); (D.B.); (C.I.C.)
| | - Ovidiu Bîcă
- “Sfânta Maria” Emergency Children Hospital Iași, 700309 Iași, Romania; (D.A.); (O.B.); (D.B.); (C.I.C.)
- 2nd Department of Morphofunctional Sciences–Cell and Molecular Biology, “Grigore T. Popa” University of Medicine and Pharmacy Iași, 700115 Iași, Romania
| | - Diana Benchia
- “Sfânta Maria” Emergency Children Hospital Iași, 700309 Iași, Romania; (D.A.); (O.B.); (D.B.); (C.I.C.)
- 2nd Department of Surgery–Pediatric Surgery and Orthopedics, “Grigore T. Popa” University of Medicine and Pharmacy Iași, 700115 Iași, Romania
| | - Ioan Sârbu
- “Sfânta Maria” Emergency Children Hospital Iași, 700309 Iași, Romania; (D.A.); (O.B.); (D.B.); (C.I.C.)
- 2nd Department of Surgery–Pediatric Surgery and Orthopedics, “Grigore T. Popa” University of Medicine and Pharmacy Iași, 700115 Iași, Romania
| | - Carmen Iulia Ciongradi
- “Sfânta Maria” Emergency Children Hospital Iași, 700309 Iași, Romania; (D.A.); (O.B.); (D.B.); (C.I.C.)
- 2nd Department of Surgery–Pediatric Surgery and Orthopedics, “Grigore T. Popa” University of Medicine and Pharmacy Iași, 700115 Iași, Romania
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Saikaly SK, Schoch JJ, Motaparthi K, Shenoy A, Knapik JA, Bender NR. Generalized infantile myofibromatosis with visceral involvement presenting as diffuse hypopigmented macules at birth. Pediatr Dermatol 2021; 38:249-252. [PMID: 33222239 DOI: 10.1111/pde.14456] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2020] [Revised: 09/23/2020] [Accepted: 10/25/2020] [Indexed: 01/04/2023]
Abstract
The initial clinical presentation of infantile myofibromatosis can vary from subtle skin changes to large tumors. Here, we describe a case of congenital generalized infantile myofibromatosis which presented with diffuse hypopigmented macules, some with subtle atrophy and telangiectasia. Further workup revealed visceral involvement which led to treatment with systemic chemotherapy. Awareness of this rare clinical presentation is crucial to expedite workup and treatment given the poor prognosis in infants with visceral involvement.
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Affiliation(s)
- Sami K Saikaly
- Department of Dermatology, University of Florida, Gainesville, FL, USA
| | - Jennifer J Schoch
- Department of Dermatology, University of Florida, Gainesville, FL, USA
| | - Kiran Motaparthi
- Department of Dermatology, University of Florida, Gainesville, FL, USA
| | - Archana Shenoy
- Department of Pathology, Immunology and Laboratory Medicine, University of Florida, Gainesville, FL, USA
| | - Jacquelyn A Knapik
- Department of Pathology, Immunology and Laboratory Medicine, University of Florida, Gainesville, FL, USA
| | - Nicole R Bender
- Department of Dermatology, University of Florida, Gainesville, FL, USA
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Fraissenon A, Benchimol G, Cabet S, Brasseur-Daudruy M, Sonigo P, Salomon LJ, Guibaud L. Prenatal imaging patterns of different forms of infantile myofibromatosis. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2020; 56:782-784. [PMID: 31909539 DOI: 10.1002/uog.21964] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/19/2019] [Revised: 12/13/2019] [Accepted: 12/20/2019] [Indexed: 06/10/2023]
Affiliation(s)
- A Fraissenon
- Imagerie Pédiatrique et Fœtale, Centre Pluridisciplinaire de Diagnostic Prénatal Consultation Multidisciplinaire des Angiomes, Hôpital Femme Mère Enfant, Université Claude Bernard Lyon 1, Lyon-Bron, France
- Service de Radiologie Mère-Enfant, Hôpital Nord, Centre Hospitalier Universitaire de Saint Etienne, Université Jean Monnet, Saint-Etienne, France
| | - G Benchimol
- Département d'Obstétrique et de Médecine Foetale, Hôpital Necker-Enfants Malades, APHP, Université Paris Descartes, Sorbonne Paris Cité, Paris, France
| | - S Cabet
- Imagerie Pédiatrique et Fœtale, Centre Pluridisciplinaire de Diagnostic Prénatal Consultation Multidisciplinaire des Angiomes, Hôpital Femme Mère Enfant, Université Claude Bernard Lyon 1, Lyon-Bron, France
| | - M Brasseur-Daudruy
- Service d'Imagerie Pédiatrique et Fœtale, Hôpital Universitaire de Rouen, Rouen, France
| | - P Sonigo
- Service de Radiopédiatrie, Hôpital Necker-Enfants Malades, APHP, Université Paris Descartes, Sorbonne Paris Cité, Paris, France
| | - L J Salomon
- Département d'Obstétrique et de Médecine Foetale, Hôpital Necker-Enfants Malades, APHP, Université Paris Descartes, Sorbonne Paris Cité, Paris, France
| | - L Guibaud
- Imagerie Pédiatrique et Fœtale, Centre Pluridisciplinaire de Diagnostic Prénatal Consultation Multidisciplinaire des Angiomes, Hôpital Femme Mère Enfant, Université Claude Bernard Lyon 1, Lyon-Bron, France
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