Trichorhinophalangeal syndrome: a case report and brief literature review

When an Overwhelming Number of Supernumerary Teeth Provides an Alternative to the Diagnosis of Trichorhinophalangeal Syndrome

Background: The prevalence of supernumerary teeth is increasing in modern dental practice. However, the presence of multiple supernumerary teeth should be further investigated. Proper diagnosis of an underlying syndrome might save the patient from future health hazards through early diagnosis and optimal follow-up screening. Case Presentation: A 13-year-old female patient presented with multiple retained deciduous teeth and delayed eruption of permanent teeth. Although the medical and family history of the patient did not raise any concerns, the clinical and radiographic examinations yielded intriguing findings. The patient presented with a total of 11 supernumerary teeth, which impeded the normal eruption of permanent dentition in addition to the presence of retained deciduous teeth. Additional clinical and laboratory investigations were conducted in response to the case's complexity, resulting in the diagnosis of Trichorhinophalangeal Syndrome (TRPS) Type I. The patient underwent a precise treatment plan and then was followed up for 6 months postoperatively to monitor the eruptive movement of the permanent teeth. Conclusion: When a syndrome is the underlying cause, monitoring unusual cases, such as those with multiple supernumerary teeth, can be lifesaving or aid in the early diagnosis of more serious complications.

A 15-Year-Old Girl with Trichorhinophalangeal Syndrome Type 1 with Non-ossifying Fibroma in Femur: A Case Report

Introduction: Trichorhinophalangeal syndrome (TRPS) is a sporadic autosomal dominant disorder with approximately 200 reported cases worldwide. We aimed to report a 15-year-old girl with TRPS type 1 (TRPS1) and the second reported case with a rare non-ossifying fibroma (NOF) in the distal part of her left femur. Case Presentation: We introduce a 15-year-old girl who presented to the outpatient rheumatology clinic at 17 Shahrivar Children's Hospital, Rasht, Iran, with the chief complaint of osteoarticular pain and bone deformities. She had sparse hair, a recession of the fronto-temporal hairline, and unusually thick eyebrows at the medial and abnormal sparseness of the lateral margins. Physical examination of the limbs revealed short fingers and toes with proximal interphalangeal (PIP) ulnar deviation of the second and third fingers in both hands. Shortness of the fourth fingers, especially in the right hand, and the swelling of the PIP joints of both hands were prominent. Genetic analysis showed deletion mutation in the TRPS1 gene in chromosome 8q24 compatible with TRPS1. Conclusions: Several symptoms and signs, including distinctive craniofacial features and ectodermal and skeletal abnormalities, are used for proper TRPS diagnosis. A correct and on-time diagnosis is essential to perform supportive care for the patient to prevent morbidities. Bone lesions, such as NOF1, can also be presented in TRPS1 patients and may be correlated with TRPS1 mutation. Further investigations are required on the association of the TRPS gene with NOF bone lesions.