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Tankam CS, Peterson MR, Tachie-Baffour Y, Zammar S, Rizk EB. Fatty filum terminale and low-lying conus medullaris in Gollop-Wolfgang complex: a case report and review of literature. Childs Nerv Syst 2023; 39:517-526. [PMID: 36155841 DOI: 10.1007/s00381-022-05679-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 09/15/2022] [Indexed: 11/03/2022]
Abstract
BACKGROUND/IMPORTANCE Gollop-Wolfgang complex is a rare skeletal dysplasia with only 200 cases reported in the literature. This disorder is usually associated with several extraosseous anomalies. This report describes the first case of a fatty filum terminale and a low-lying conus medullaris in a patient with this complex. A review of the current literature of the Gollop-Wolfgang complex accompanies this case, highlighting the documented extraosseous anomalies seen in this complex. CLINICAL PRESENTATION We report a case of an 18-month-old patient with Gollop-Wolfgang complex who underwent cord untethering with release of the filum terminale after extensive workup showed the presence of a dyssynergic bladder and radiological evaluation revealed a fatty filum terminale and low-lying conus medullaris. CONCLUSION Gollop-Wolfgang complex is a skeletal dysplasia usually associated with several extra skeletal anomalies. Our report describes the first case of a fatty filum terminale and low-lying conus medullaris in this complex, as well as provides an overview of the documented anomalies seen in this disorder. A multidisciplinary approach is recommended when treating these infants in order to ensure that occult manifestations of the complex are not missed.
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Affiliation(s)
- Cyril S Tankam
- Department of Neurosurgery, Penn State Children's Hospital, 30 Hope Drive, Suite 1200, Building B, Hershey, PA, 1733, USA.
| | - Mallory R Peterson
- Department of Neurosurgery, Penn State Children's Hospital, 30 Hope Drive, Suite 1200, Building B, Hershey, PA, 1733, USA
| | - Yaw Tachie-Baffour
- Department of Neurosurgery, Penn State Children's Hospital, 30 Hope Drive, Suite 1200, Building B, Hershey, PA, 1733, USA
| | - Samer Zammar
- Department of Neurosurgery, Penn State Children's Hospital, 30 Hope Drive, Suite 1200, Building B, Hershey, PA, 1733, USA
| | - Elias B Rizk
- Department of Neurosurgery, Penn State Children's Hospital, 30 Hope Drive, Suite 1200, Building B, Hershey, PA, 1733, USA
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Dalal J, Chhari P, Dayanand S, Singh J, Dalal M. Complete agenesis of tibia with bilateral bifid femurs in a neonate - A rare variant of Gollop-Wolfgang complex. MEDICAL JOURNAL OF DR. D.Y. PATIL VIDYAPEETH 2022. [DOI: 10.4103/mjdrdypu.mjdrdypu_369_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Vanderberg RH, Block T, Gates T, Gomez J. Gollop-Wolfgang Complex: Clinical and Imaging Implications. Indian J Radiol Imaging 2021; 31:721-724. [PMID: 34790323 PMCID: PMC8590539 DOI: 10.1055/s-0041-1736396] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Gollop-Wolfgang complex is defined as the presence of a distal bifid femur and tibial hemimelia with or without hand ectrodactyly. The condition commonly presents with several skeletal abnormalities and internal organ congenital defects. We hereby report a case with a classical presentation of Gollop-Wolfgang complex.
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Affiliation(s)
- Robert Hunter Vanderberg
- Department of Radiology, Louisiana State University Health Science Center, Shreveport, Louisiana, United States
| | - Thomas Block
- Department of Radiology, Louisiana State University Health Science Center, Shreveport, Louisiana, United States
| | - Thomas Gates
- Department of Radiology, Louisiana State University Health Science Center, Shreveport, Louisiana, United States
| | - Juan Gomez
- Department of Radiology, Louisiana State University Health Science Center, Shreveport, Louisiana, United States
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A 20 bp Duplication in Exon 2 of the Aristaless-Like Homeobox 4 Gene (ALX4) Is the Candidate Causative Mutation for Tibial Hemimelia Syndrome in Galloway Cattle. PLoS One 2015; 10:e0129208. [PMID: 26076463 PMCID: PMC4468193 DOI: 10.1371/journal.pone.0129208] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2015] [Accepted: 05/06/2015] [Indexed: 11/20/2022] Open
Abstract
Aristaless-like homeobox 4 (ALX4) gene is an important transcription regulator in skull and limb development. In humans and mice ALX4 mutations or loss of function result in a number of skeletal and organ malformations, including polydactyly, tibial hemimelia, omphalocele, biparietal foramina, impaired mammary epithelial morphogenesis, alopecia, coronal craniosynostosis, hypertelorism, depressed nasal bridge and ridge, bifid nasal tip, hypogonadism, and body agenesis. Here we show that a complex skeletal malformation of the hind limb in Galloway cattle together with other developmental anomalies is a recessive autosomal disorder most likely caused by a duplication of 20 bp in exon 2 of the bovine ALX4 gene. A second duplication of 34 bp in exon 4 of the same gene has no known effect, although both duplications result in a frameshift and premature stop codon leading to a truncated protein. Genotyping of 1,688 Black/Red/Belted/Riggit Galloway (GA) and 289 White Galloway (WGA) cattle showed that the duplication in exon 2 has allele frequencies of 1% in GA and 6% in WGA and the duplication in exon 4 has frequencies of 23% in GA and 38% in WGA. Both duplications were not detected in 876 randomly selected German Holstein Friesian and 86 cattle of 21 other breeds. Hence, we have identified a candidate causative mutation for tibial hemimelia syndrome in Galloway cattle and selection against this mutation can be used to eliminate the mutant allele from the breed.
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Qureshi IA, Gudepu RK, Chava R, Emmani S, Asghar SH, Qureshi MA, Arlappa N. Case Report: Gollop-Wolfgang Complex in a 5 month old baby. F1000Res 2014; 3:315. [PMID: 26064472 PMCID: PMC4448748 DOI: 10.12688/f1000research.5889.3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/23/2015] [Indexed: 11/20/2022] Open
Abstract
Skeletal dysplasias are disorders associated with a generalized abnormality in the skeleton. The Gollop-Wolfgang complex (GWC) is a limb deficiency disorder and an unusual limb malformation with highly variable manifestations. Here we report an interesting case of a 5-month old male baby from India with Gollop-Wolfgang Complex showing bifurcation of the right femur, ectrodactyly of both feet, ectrodactyly of left hand, syndactyly of right hand and unusual presentation of bilateral fibular agenesis and caudal (Sacrococcygeal) agenesis. The etiology of GWC in this 5 month old male baby could possibly be attributed to spontaneous gene mutation. The clinical, radiographic findings and the unusual presentation are presented in detail.
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Affiliation(s)
- Ihtesham A Qureshi
- Division of Community Studies, National Institute of Nutrition, Indian Council of Medical Research, Hyderabad, 500 007, India
| | - Rohit Kumar Gudepu
- Division of Community Studies, National Institute of Nutrition, Indian Council of Medical Research, Hyderabad, 500 007, India
| | - Ravikanth Chava
- Division of Community Studies, National Institute of Nutrition, Indian Council of Medical Research, Hyderabad, 500 007, India
| | - Sravya Emmani
- Division of Community Studies, National Institute of Nutrition, Indian Council of Medical Research, Hyderabad, 500 007, India
| | - Syed Husain Asghar
- Division of Community Studies, National Institute of Nutrition, Indian Council of Medical Research, Hyderabad, 500 007, India
| | - Mohtashim A Qureshi
- Division of Community Studies, National Institute of Nutrition, Indian Council of Medical Research, Hyderabad, 500 007, India
| | - Nimmathota Arlappa
- Division of Community Studies, National Institute of Nutrition, Indian Council of Medical Research, Hyderabad, 500 007, India
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Chinnakkannan S, Das RR, Rughmini K, Ahmed S. A case of bilateral tibial hemimelia type VIIa. INDIAN JOURNAL OF HUMAN GENETICS 2013; 19:108-10. [PMID: 23901205 PMCID: PMC3722620 DOI: 10.4103/0971-6866.112924] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Congenital absence of tibia is a rare anomaly, and may be total or partial, unilateral or bilateral. Total absence is more frequent than partial, unilateral absence occurs more often than bilateral, with right limb more commonly affected than the left. In partial defect, almost always the distal end of the bone is affected, and of the bilateral cases, there may be total absence on both sides, or total on one side and partial on the other. Males are slightly more commonly affected than the females. Though, the family history is usually negative for congenital abnormalities and other diseases, there is a considerable chance of occurrence of congenital defect of the tibia or of other abnormalities, in near or remote relatives. We report a case of newborn having bilateral tibial hemimelia type VIIa.
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Kadir KHMS, Abdul Rashid AH, Das S, Ibrahim S. A rare case of diplopodia and syndactyly: anatomical and surgical considerations. J Foot Ankle Surg 2011; 50:252-6. [PMID: 21354013 DOI: 10.1053/j.jfas.2010.10.017] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2010] [Indexed: 02/03/2023]
Abstract
Diplopodia is a rare congenital disorder that has not been extensively discussed in textbooks, and case reports appear to be the main source of information. Although the exact cause of diplopodia remains unknown, the presence of extra digits as well as metatarsals and tarsals allows it to be differentiated from pedal polydactyly. Syndactyly refers to the congenital fusion of the digits. Concomitant bilateral syndactyly and diplopodia is extremely unusual, and in this report we describe a case of right diplopodia and left polydactyly combined with bilateral manual syndactyly in a 15-year-old girl who was ultimately treated with through-the-knee amputation. Radiological examination of the right leg revealed tibial hypoplasia and the right foot displayed 8 digits with corresponding metatarsals and tarsals, whereas the left leg revealed 2 extra digits on the medial aspect of the foot with corresponding metatarsal and tarsal bones. Anatomical dissection of the right foot revealed that it was divided into halves consisting of 8 toes with corresponding metatarsals and tarsals, as well as tibial hypoplasia and absence of the great toe. Diplopodia associated with tibial hypoplasia and syndactyly can be treated surgically, and the present case report details the clinical, radiological, and anatomical elements of this rare deformity.
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Affiliation(s)
- Kamarulzaman Haji M S Kadir
- Department of Orthopaedics and Traumatology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Bandar Tun Razak, Kuala Lumpur, Malaysia
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Alessandri J, Isidor B, David A, Martin-Coignard D, Ghazouani J, Ramful D, Laville J, Le Caignec C. Tibial developmental field defect in valproic acid embryopathy: Report on three cases. Am J Med Genet A 2010; 152A:2805-9. [DOI: 10.1002/ajmg.a.33633] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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A patient with unilateral tibial aplasia and accessory scrotum: a pure coincidence or nonfortuitous association? Case Rep Med 2010; 2010:898636. [PMID: 20148169 PMCID: PMC2817541 DOI: 10.1155/2010/898636] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2009] [Accepted: 01/07/2010] [Indexed: 11/18/2022] Open
Abstract
Tibial aplasia is an uncommon lower limb malformation that can occur isolated or be part of a more complex malformation pattern. We describe a 9-year-old boy born after uneventful pregnancy and delivery. Family history was negative for maternal diabetes and other malformations. The patient presented with left tibial aplasia and homolateral prexial foot polydactyly. He also displayed enamel dysplasia and bifid scotum with cryptorchidism. Literature review failed to identify a significant syndromic association between lower limb defects of the tibial type and the genital anomalies reported here. The combination of tibial aplasia with midline genital malformations further supports the hypothesis that the tibial ray development mirrors the morphogenetic process of the radial structures. Accordingly, the malformation pattern observed in the present patient may be pathogenetically explained by an insult occurring during late blastogenesis.
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Mendilcioglu I, Mihci E, Pestereli E, Simsek M. Prenatal diagnosis of Gollop-Wolfgang complex (tibial agenesis and femoral bifurcation). Prenat Diagn 2009; 29:182-6. [PMID: 19180625 DOI: 10.1002/pd.2204] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Inanc Mendilcioglu
- Department of Obstetrics and Gynecology, School of Medicine, Akdeniz University, Antalya, Turkey.
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Tibial developmental field defect is the most common lower limb malformation pattern in VACTERL association. Am J Med Genet A 2008; 146A:1259-66. [DOI: 10.1002/ajmg.a.32288] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Abstract
Congenital absence of tibia is a rare anomaly. We report a case of bilateral tibial hemimelia born to phenotypically normal parents. The two amputated legs with tibial dysplasia obtained from a 3-year-old boy were studied by radiography and anatomical dissection. The radiological evaluation revealed a normal hip joint. The lower end of femur was normal without any bifurcation, shortening or bowing. Fibula was present on both legs and there was no sign of bowing or doubling. Both right and left tibiae were absent. In addition, on the right side, five tarsal bones, two metatarsals and the corresponding digital rays were absent. On the left side, three tarsal bones were absent. Dissection of the amputated segments showed the presence of extensor digitorum longus, peroneus tertius, peroneus longus and brevis, gastrocnemius, and soleus. Following bilateral knee disarticulation the patient was fitted with prosthesis and is doing well.
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Affiliation(s)
- J Suganthy
- Department of Anatomy, Christian Medical College, Vellore, India.
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