Skeletal anomalies and keratocysts in the basal cell nevus syndrome

Nevoid Basal Cell Carcinoma Syndrome: A Long-Term Study in a Family

We present a family case series with 10 individuals having nevoid basal cell carcinoma syndrome (NBCCS) with a 10-year follow-up. All articles published in the literature between 1967 and 2011 on familial Gorlin-Goltz syndrome in any language were surveyed to determine the mapping of cases per country of occurrence of this disease. All patients in the present series were presented with calcification of the falx cerebri, mild hypertelorism, and frontal bossing. Odontogenic keratocystic tumors, palmar and plantar pits, and multiple basal cell carcinomas occurred in 90, 40, and 20%, respectively, of the patients. One of the patients died of skin cancer. Diagnosis of odontogenic keratocyst tumors was confirmed by histopathological examination. NBCCS is a rare autosomal dominant cancer predisposition syndrome; it is important to recognize it when a patient has multiple odontogenic keratocyst tumors because life-long monitoring is essential for patient management.

Nevoid Basal cell carcinoma syndrome: a cephalometric study of patients and controls

Craniofacial morphology of patients with nevoid basal cell carcinoma syndrome (NBCCS) has sometimes been reported at clinical examination, but any investigation has described it on the basis of cephalometric measurements.The purpose of this study was to conduct a cephalometric analysis of patients with NBCCS and to compare measurements with non-NBCCS subjects of similar ages, to elucidate if there is any relationship between NBCCS and craniofacial morphology.The study population consisted of 14 adult patients (9 men and 5 women), ranging in age from 18.2 to 56.8 years, with the diagnosis of NBCCS, with good-quality lateral cephalometric radiographs, and 14 adult healthy patients matched for age and sex to the NBCCS group. Cephalometric measurements were carried out on radiographs, and measurements of angles and distances were performed.Statistical differences between NBCCS subjects and controls were observed. Data analysis displayed that the measurements of the anterior cranial base (P <or= 0.0043), mandibular length (P <or= 0.0168), and maxillary length (P <or= 0.0284), posterior facial height (P <or= 0.0406), and of mandibular angle (P <or= 0.0026), facial axis angle (P <or= 0.0402), lower facial height angles (P <or= 0.0135), and of interincisal angulation (P <or= 0.0148) were higher in NBCCS subjects in respect to controls. On the contrary, the facial convexity (P <or= 0.0189) and the mandibular arc angle (P <or= 0.0378) were reduced in NBCCS subjects.According to these findings, NBCCS patients presented a sagittal lengthening of the anterior cranial base and maxilla and a vertically and horizontally overdeveloped mandible, together with the features of a long-face syndrome with a large gonial angle.

Examine your orofacial cleft patients for Gorlin-Goltz syndrome

The Gorlin-Goltz syndrome is characterized by four primary symptoms: multiple nevoid basal cell epitheliomas that usually undergo malignant transformation; jaw keratocysts that show constant growth; skeletal anomalies; and intracranial calcifications. A myriad of additional findings may also be noted. Among the most frequent are: palmar and plantar pits, a characteristic flattened facies and broad nasal root, frontal and parietal bossing, mandibular prognathia, hypertelorism, strabismus, dystrophia of the canthi, and clefts of the lip, alveolus, and/or palate. In this study, we review the literature and our 25 cases of Gorlin-Goltz syndrome patients, questioning their incidence of cleft formations (8.5%) as compared to the general population (0.1%). It is our contention that all patients who present with an orofacial cleft warrant deeper investigation as to the presence of additional signs indicative of Gorlin-Goltz syndrome. The nevi turn malignant with time, and thus, early diagnosis, follow-up, and treatment are imperative.

Unusual presentation of a third ventricular cyst in a patient with basal cell nevus syndrome

Patients with basil cell nevus syndrome often have neurologic manifestations that occasionally cause complications. I report a case of a third ventricular cyst causing unusual symptoms in a 16-year-old boy. The discussion includes a review of the various neurologic signs and symptoms in this syndrome.

Ocular hypertelorism, facial basal cell carcinomas, and multiple odontogenic keratocysts of the jaws

Dentists should be aware of the multiple jaw cysts of NBCS that may develop in patients as young as 7 to 8 years. As the jaw cysts frequently are the initial symptom, dentists have the opportunity to detect the syndrome early, before the patients seek medical treatment. Any young patient with multiple odontogenic keratocysts in the jaws can develop other conditions characteristic of the disease. A careful family history should be taken, and the patient should be monitored closely for subsequent clinical manifestations of the disease.

The naevoid basal cell carcinoma syndrome. Clinical, biochemical and radiological aspects

Eight living patients with the nevoid basal cell carcinoma syndrome (NBS) underwent a clinical and radiological examination, and data on a deceased patient was included. Cerebral CT-scannings were performed on eight patients, and calcification in the falx and tentorium cerebelli was found in all patients but one. Congenital hydrocephalus or agenesis of the corpus callosum could not be demonstrated. Laboratory results, including serum levels of alpha 1-antitrypsin and alpha 2-macroglobulin, haptoglobin, inorganic phosphorus, alkaline phosphatase and calcium, were normal in all patients but two. It is postulated that elevated serum alkaline phosphatase in patients with NBS is correlated to the presence of growing odontogenic keratocysts.

The association of cleft lip and palate with basal cell nevus syndrome

The literature concerning the association of the basal cell nevus syndrome with cleft lip and/or palate is surveyed. Seventeen cases, including two of our own patients, are discussed. Fifteen of the patients were males. Orofacial clefting appears to be an uncommon but definite symptom of the basal cell nevus syndrome. The male-female ratio of clefting in this syndrome is statistically not different from the ratio in the normal population.

Multiple basal cell naevi syndrome: management of the young patient

The principal features of the Multiple Basal Cell Naevi Syndrome are reviewed and the case of a seven-year-old child is described. The diagnosis and the management of young patients with this syndrome are discussed.

Gorlin's syndrome and the heart

Three further cases of the Multiple Basal Cell Naevi Syndrome are added to the literature. One case developed a neonatal left ventricular fibroma, subsequently successfully excised. An association between the syndrome and cardiac tumours has not been documented before, and the relative frequencies of the two conditions are discussed. Biochemical, radiological and chromosomal studies are evaluated and the rate of growth of odontogenic keratocysts discussed.