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Burke AB. Craniomaxillofacial Fibro-osseous Lesions in Children. Oral Maxillofac Surg Clin North Am 2024; 36:379-390. [PMID: 38705816 DOI: 10.1016/j.coms.2024.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/07/2024]
Abstract
Craniofacial fibro-osseous lesions represent a diverse spectrum of pathologic conditions where fibrous tissue replaces healthy bone, resulting in the formation of irregular, woven bone. They are more commonly diagnosed in young people, with treatment strategies dependent on clinical behavior and skeletal maturity. This article discusses the examples of craniofacial fibro-osseous lesions, based on the latest classifications, along with their diagnostic criteria and management.
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Affiliation(s)
- Andrea B Burke
- Department of Oral and Maxillofacial Surgery, University of Washington School of Dentistry, 1959 Northeast Pacific Street, Box 357134, Seattle, WA 98195-7134, USA.
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2
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Akintoye SO, Adisa AO, Okwuosa CU, Mupparapu M. Craniofacial disorders and dysplasias: Molecular, clinical, and management perspectives. Bone Rep 2024; 20:101747. [PMID: 38566929 PMCID: PMC10985038 DOI: 10.1016/j.bonr.2024.101747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 02/27/2024] [Accepted: 02/29/2024] [Indexed: 04/04/2024] Open
Abstract
There is a wide spectrum of craniofacial bone disorders and dysplasias because embryological development of the craniofacial region is complex. Classification of craniofacial bone disorders and dysplasias is also complex because they exhibit complex clinical, pathological, and molecular heterogeneity. Most craniofacial disorders and dysplasias are rare but they present an array of phenotypes that functionally impact the orofacial complex. Management of craniofacial disorders is a multidisciplinary approach that involves the collaborative efforts of multiple professionals. This review provides an overview of the complexity of craniofacial disorders and dysplasias from molecular, clinical, and management perspectives.
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Affiliation(s)
- Sunday O. Akintoye
- Department of Oral Medicine, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA, United States of America
| | - Akinyele O. Adisa
- University of Ibadan and University College Hospital Ibadan, Ibadan, Nigeria
| | - Chukwubuzor U. Okwuosa
- Department of Oral Pathology & Oral Medicine, University of Nigeria Teaching Hospital, Ituku-Ozalla, Nigeria
| | - Mel Mupparapu
- Department of Oral Medicine, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA, United States of America
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3
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Billar RJ, Manoubi W, Kant SG, Wijnen RMH, Demirdas S, Schnater JM. Association between pectus excavatum and congenital genetic disorders: A systematic review and practical guide for the treating physician. J Pediatr Surg 2021; 56:2239-2252. [PMID: 34039477 DOI: 10.1016/j.jpedsurg.2021.04.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 04/13/2021] [Accepted: 04/18/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Pectus excavatum (PE) could be part of a genetic disorder, which then has implications regarding comorbidity, the surgical correction of PE, and reproductive choices. However, referral of a patient presenting with PE for genetic analysis is often delayed because additional crucial clinical signs may be subtle or even missed in syndromic patients. We reviewed the literature to inventory known genetic disorders associated with PE and create a standardized protocol for clinical evaluation. METHODS A systematic literature search was performed in electronic databases. Genetic disorders were considered associated with PE if studies reported at least five cases with PE. Characteristics of each genetic disorder were extracted from the literature and the OMIM database in order to create a practical guide for the clinician. RESULTS After removal of duplicates from the initial search, 1632 citations remained. Eventually, we included 119 full text articles, representing 20 different genetic disorders. Relevant characteristics and important clinical signs of each genetic disorder were summarized providing a standardized protocol in the form of a scoring list. The most important clinical sign was a positive family history for PE and/or congenital heart defect. CONCLUSIONS Twenty unique genetic disorders have been found associated with PE. We have created a scoring list for the clinician that systematically evaluates crucial clinical signs, thereby facilitating decision making for referral to a clinical geneticist.
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Affiliation(s)
- Ryan J Billar
- Erasmus University Medical Center - Sophia Children's Hospital, department of Paediatric Surgery Rotterdam, Netherlands
| | - Wiem Manoubi
- Erasmus University Medical Centre, department of Neuroscience, Rotterdam, Netherlands
| | - Sarina G Kant
- Erasmus University Medical Centre, department of Clinical Genetics, Rotterdam, Netherlands
| | - René M H Wijnen
- Erasmus University Medical Center - Sophia Children's Hospital, department of Paediatric Surgery Rotterdam, Netherlands
| | - Serwet Demirdas
- Erasmus University Medical Centre, department of Clinical Genetics, Rotterdam, Netherlands
| | - Johannes M Schnater
- Erasmus University Medical Center - Sophia Children's Hospital, department of Paediatric Surgery Rotterdam, Netherlands.
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4
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Schreuder WH, van der Wal JE, de Lange J, van den Berg H. Multiple versus solitary giant cell lesions of the jaw: Similar or distinct entities? Bone 2021; 149:115935. [PMID: 33771761 DOI: 10.1016/j.bone.2021.115935] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2020] [Revised: 02/27/2021] [Accepted: 03/17/2021] [Indexed: 02/06/2023]
Abstract
The majority of giant cell lesions of the jaw present as a solitary focus of disease in bones of the maxillofacial skeleton. Less frequently they occur as multifocal lesions. This raises the clinical dilemma if these should be considered distinct entities and therefore each need a specific therapeutic approach. Solitary giant cell lesions of the jaw present with a great diversity of symptoms. Recent molecular analysis revealed that these are associated with somatic gain-of-function mutations in KRAS, FGFR1 or TRPV4 in a large component of the mononuclear stromal cells which all act on the RAS/MAPK pathway. For multifocal lesions, a small group of neoplastic multifocal giant cell lesions of the jaw remain after ruling out hyperparathyroidism. Strikingly, most of these patients are diagnosed with jaw lesions before the age of 20 years, thus before the completion of dental and jaw development. These multifocal lesions are often accompanied by a diagnosis or strong clinical suspicion of a syndrome. Many of the frequently reported syndromes belong to the so-called RASopathies, with germline or mosaic mutations leading to downstream upregulation of the RAS/MAPK pathway. The other frequently reported syndrome is cherubism, with gain-of-function mutations in the SH3BP2 gene leading through assumed and unknown signaling to an autoinflammatory bone disorder with hyperactive osteoclasts and defective osteoblastogenesis. Based on this extensive literature review, a RAS/MAPK pathway activation is hypothesized in all giant cell lesions of the jaw. The different interaction between and contribution of deregulated signaling in individual cell lineages and crosstalk with other pathways among the different germline- and non-germline-based alterations causing giant cell lesions of the jaw can be explanatory for the characteristic clinical features. As such, this might also aid in the understanding of the age-dependent symptomatology of syndrome associated giant cell lesions of the jaw; hopefully guiding ideal timing when installing treatment strategies in the future.
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Affiliation(s)
- Willem H Schreuder
- Department of Oral and Maxillofacial Surgery, Amsterdam UMC and Academic Center for Dentistry Amsterdam, University of Amsterdam, Amsterdam, the Netherlands; Department of Head and Neck Surgery and Oncology, Antoni van Leeuwenhoek / Netherlands Cancer Institute, Amsterdam, the Netherlands.
| | - Jacqueline E van der Wal
- Department of Pathology, Antoni van Leeuwenhoek / Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Jan de Lange
- Department of Oral and Maxillofacial Surgery, Amsterdam UMC and Academic Center for Dentistry Amsterdam, University of Amsterdam, Amsterdam, the Netherlands
| | - Henk van den Berg
- Department of Pediatrics / Oncology, Amsterdam UMC, University of Amsterdam, Emma Children's Hospital, Amsterdam, the Netherlands
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5
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Bertola DR, Castro MAA, Yamamoto GL, Honjo RS, Ceroni JR, Buscarilli MM, Freitas AB, Malaquias AC, Pereira AC, Jorge AAL, Passos‐Bueno MR, Kim CA. Phenotype–genotype analysis of 242 individuals with
RASopathies
: 18‐year experience of a tertiary center in Brazil. AMERICAN JOURNAL OF MEDICAL GENETICS PART C-SEMINARS IN MEDICAL GENETICS 2020; 184:896-911. [DOI: 10.1002/ajmg.c.31851] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 10/15/2020] [Accepted: 10/20/2020] [Indexed: 12/23/2022]
Affiliation(s)
- Débora R. Bertola
- Unidade de Genética Instituto da Criança do Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo São Paulo Brazil
- Instituto de Biociências Universidade de São Paulo São Paulo Brazil
| | - Matheus A. A. Castro
- Unidade de Genética Instituto da Criança do Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo São Paulo Brazil
| | - Guilherme L. Yamamoto
- Unidade de Genética Instituto da Criança do Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo São Paulo Brazil
| | - Rachel S. Honjo
- Unidade de Genética Instituto da Criança do Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo São Paulo Brazil
| | - José Ricardo Ceroni
- Unidade de Genética Instituto da Criança do Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo São Paulo Brazil
| | - Michele M. Buscarilli
- Unidade de Genética Instituto da Criança do Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo São Paulo Brazil
| | - Amanda B. Freitas
- Unidade de Genética Instituto da Criança do Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo São Paulo Brazil
| | - Alexsandra C. Malaquias
- Unidade de Endocrinologia‐Genetica LIM 25, Disciplina de Endocrinologia da Faculdade de Medicina da Universidade de Sao Paulo São Paulo Brazil
| | - Alexandre C. Pereira
- Laboratório de Genética e Cardiologia Molecular Instituto do Coração, do Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo São Paulo Brazil
| | - Alexander A. L. Jorge
- Unidade de Endocrinologia‐Genetica LIM 25, Disciplina de Endocrinologia da Faculdade de Medicina da Universidade de Sao Paulo São Paulo Brazil
| | | | - Chong A. Kim
- Unidade de Genética Instituto da Criança do Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo São Paulo Brazil
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Lutz JC, Nicot R, Schlund M, Schaefer E, Bornert F, Fioretti F, Ferri J. Dental and maxillofacial features of Noonan Syndrome: Case series of ten patients. J Craniomaxillofac Surg 2020; 48:242-250. [PMID: 32113883 DOI: 10.1016/j.jcms.2020.01.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Revised: 01/22/2020] [Accepted: 01/26/2020] [Indexed: 12/28/2022] Open
Abstract
Noonan syndrome (NS) is a relatively common congenital multiple-anomaly syndrome, resembling Turner syndrome, but without chromosomal anomaly. Besides the unusual facies, the maxillofacial and dental features of patients with NS are not well-summarized in the literature. The aim of this study was to describe these features and propose specific treatment guidelines for practitioners involved in oral and maxillofacial care. A retrospective multicentric study was conducted of 14 patients who were referred for NS screening. In total, 10 patients were found to carry a mutation involved in NS or NS-related disorders. Fifty percent of the mutations affected PTPN11. All patients presented with the typical extraoral features, such as macrocephaly, hypertelorism, ptosis, triangular face shape and ear dystrophy. Intraoral manifestations, including malocclusion (maxillary transversal deficiency, crossbite, anterior open-bite and class II malocclusion), dental anomalies (delayed eruption, agenesis and dystrophy, odontoma) and radiologic jaw lesions were identified in five out of 10 patients. These findings were searched in a review of the literature to obtain a comprehensive description of oral and maxillofacial features in patients with NS. The proposed treatment guidelines emphasize frequent coagulation anomalies that need to be considered prior to surgery. Early dental assessment and yearly follow-up with oral prophylaxis are recommended. Orthodontics and orthognathic surgery are also of primary importance in the management of NS patients.
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Affiliation(s)
- Jean-Christophe Lutz
- Oral and Maxillofacial Surgery Department, Strasbourg University Hospital, 1 avenue Molière, 67098, Strasbourg cedex, France; University of Strasbourg, Faculty of Medicine, 8 rue Kirschleger, 67000, Strasbourg, France; INSERM (French National Institute of Health and Medical Research), "Regenerative Nanomedicine" Laboratory, UMR 1260, Faculté de Médecine, FMTS, 67085, Strasbourg cedex, France.
| | - Romain Nicot
- Oral and Maxillofacial Surgery Department, Roger Salengro Hospital, Avenue du Professeur Emile Laine, 59037, Lille, France; Université Lille 2 Droit et Santé, 1 Pl. de Verdun, 59000, Lille, France; INSERM U1008, Controlled Drug Delivery Systems and Biomaterials, Faculté de Pharmacie, 3, rue du Professeur Laguesse, BP83, 59006, Lille Cedex, France
| | - Matthias Schlund
- Oral and Maxillofacial Surgery Department, Roger Salengro Hospital, Avenue du Professeur Emile Laine, 59037, Lille, France; Université Lille 2 Droit et Santé, 1 Pl. de Verdun, 59000, Lille, France
| | - Elise Schaefer
- University of Strasbourg, Faculty of Medicine, 8 rue Kirschleger, 67000, Strasbourg, France; Medical Genetics Department, Strasbourg University Hospital, 1 avenue Molière, 67098, Strasbourg cedex, France
| | - Fabien Bornert
- INSERM (French National Institute of Health and Medical Research), "Regenerative Nanomedicine" Laboratory, UMR 1260, Faculté de Médecine, FMTS, 67085, Strasbourg cedex, France; Department of Dentistry / Oral Medicine and Oral Surgery, Strasbourg University Hospital, 1 Place de l'Hôpital, 67091, Strasbourg cedex, France; University of Strasbourg, Faculty of Dentistry, 8 rue Sainte Elisabeth, 67000, Strasbourg, France
| | - Florence Fioretti
- INSERM (French National Institute of Health and Medical Research), "Regenerative Nanomedicine" Laboratory, UMR 1260, Faculté de Médecine, FMTS, 67085, Strasbourg cedex, France; Department of Dentistry / Oral Medicine and Oral Surgery, Strasbourg University Hospital, 1 Place de l'Hôpital, 67091, Strasbourg cedex, France; University of Strasbourg, Faculty of Dentistry, 8 rue Sainte Elisabeth, 67000, Strasbourg, France
| | - Joël Ferri
- Oral and Maxillofacial Surgery Department, Roger Salengro Hospital, Avenue du Professeur Emile Laine, 59037, Lille, France; Université Lille 2 Droit et Santé, 1 Pl. de Verdun, 59000, Lille, France; INSERM U1008, Controlled Drug Delivery Systems and Biomaterials, Faculté de Pharmacie, 3, rue du Professeur Laguesse, BP83, 59006, Lille Cedex, France
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7
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Rodríguez FA, Castellón L, Moreno R, Paez E, Aracena Álvarez MI. Noonan syndrome with multiple Giant cell lesions, management and treatment with surgery and interferon alpha-2a therapy: Case report. Birth Defects Res 2020; 112:732-739. [PMID: 32065515 DOI: 10.1002/bdr2.1659] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Accepted: 02/06/2020] [Indexed: 01/08/2023]
Abstract
We report the case of a 14-year-old girl that was referred to the maxillo facial surgery unit at age 11 years because she exhibited swelling in the right side of her maxilla and right mandible. After a conservative surgery, she started with interferon alpha-2a to avoid recurrence. She has remained in treatment with successful results during her follow up. Considerable reduction of both maxilla and mandible lesions and bone fill have been documented. In addition, her clinical history and phenotype were suggestive of Noonan syndrome. She has short stature, broad and short neck; hypertelorism (increased distance between the eyes); downslanting palpebral fissures; sparse eyebrows and eyelashes; posteriorly rotated ears with fleshy lobes; follicular keratosis over the face, and developmental delay. Her karyotype was 46, XX. Molecular analysis of RAS/MAPK pathway genes showed a SOS1 amino acid substitution of arginine to lysine at position 552 (p.R552K). This case presents the infrequent condition of Noonan syndrome with multiple giant cell lesions (NS/MGCL) that would be the first patient as far as we know treated with surgery and interferon alpha-2a for her giant cell lesions.
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Affiliation(s)
| | - Loreto Castellón
- Maxillofacial Unit, Hospital Dr. Luis Calvo Mackenna, Santiago, Chile
| | - Regina Moreno
- Unidad de Genética, Genética - Clínica Alemana, Temuco, Chile
| | - Eduardo Paez
- Hemato - Oncology Unit, Hospital Dr. Hernán Henríquez Aravena, Temuco, Chile
| | - Mariana Inés Aracena Álvarez
- Unit of Genetics and Metabolic diseases, Division of Pediatrics, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile.,Unit of Genetics, Hospital Dr. Luis Calvo Mackenna, Santiago, Chile
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8
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Rotman LE, Hackney JR, McGrew BM, Fisher WS, Rozzelle CJ. Chondroblastoma-like mass of the temporal bone, secondary aneurysmal bone cyst, and intracerebral hemorrhage in a patient with cardiofaciocutaneous syndrome: case report. J Neurosurg Pediatr 2019; 24:153-158. [PMID: 31125963 DOI: 10.3171/2019.3.peds18607] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2018] [Accepted: 03/29/2019] [Indexed: 12/17/2022]
Abstract
Cardiofaciocutaneous syndrome (CFCS) is a rare developmental disorder that is phenotypically similar to Noonan syndrome and is associated with mutations in BRAF, MEK1, MEK2, and KRAS. The relationship between malignancy risk and CFCS is unclear with few cases published in the literature. The purpose of this paper is to describe the case of a patient with CFCS presenting in extremis as a result of a large intracerebral hemorrhage arising from a temporal bone mass with histopathology most consistent with chondroblastoma and secondary aneurysmal bone cyst. This is the first case to document an association between CFCS and chondroblastoma.
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9
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Multifocal Pigmented Villonodular Synovitis in the Noonan Syndrome. Case Rep Orthop 2018; 2018:7698052. [PMID: 30631623 PMCID: PMC6305014 DOI: 10.1155/2018/7698052] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Revised: 10/24/2018] [Accepted: 11/25/2018] [Indexed: 11/24/2022] Open
Abstract
Noonan-like/multiple giant cell lesion (NS/MGCL) is a rare condition overlapping with Noonan syndrome. Once thought to be a specific and separate entity, it is now suggested to be a variant of the Noonan syndrome spectrum. We report the case of an 8-year-old boy with a typical clinical picture of Noonan syndrome with a de novo germline mutation of PTPN11 (c.854 T>C). During his follow-up, the patient developed multifocal pigmented villonodular synovitis which first affected the left knee and shortly after both elbows.
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10
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Harms FL, Alawi M, Amor DJ, Tan TY, Cuturilo G, Lissewski C, Brinkmann J, Schanze D, Kutsche K, Zenker M. The novel RAF1 mutation p.(Gly361Ala) located outside the kinase domain of the CR3 region in two patients with Noonan syndrome, including one with a rare brain tumor. Am J Med Genet A 2017; 176:470-476. [PMID: 29271604 DOI: 10.1002/ajmg.a.38569] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2017] [Revised: 09/29/2017] [Accepted: 11/16/2017] [Indexed: 11/07/2022]
Abstract
Noonan syndrome is characterized by typical craniofacial dysmorphism, postnatal growth retardation, congenital heart defect, and learning difficulties and belongs to the RASopathies, a group of neurodevelopmental disorders caused by germline mutations in genes encoding components of the RAS-MAPK pathway. Mutations in the RAF1 gene are associated with Noonan syndrome, with a high prevalence of hypertrophic cardiomyopathy (HCM). RAF1 mutations cluster in exons encoding the conserved region 2 (CR2), the kinase activation segment of the CR3 domain, and the C-terminus. We present two boys with Noonan syndrome and the identical de novo RAF1 missense variant c.1082G>C/p.(Gly361Ala) affecting the CR3, but located outside the kinase activation segment. The p.(Gly361Ala) mutation has been identified as a RAF1 allele conferring resistance to RAF inhibitors. This amino acid change favors a RAF1 conformation that allows for enhanced RAF dimerization and increased intrinsic kinase activity. Both patients with Noonan syndrome showed typical craniofacial dysmorphism, macrocephaly, and short stature. One individual developed HCM and was diagnosed with a disseminated oligodendroglial-like leptomeningeal tumor (DOLT) of childhood at the age of 9 years. While there is a well-established association of NS with malignant tumors, especially childhood hemato-oncological diseases, brain tumors have rarely been reported in Noonan syndrome. Our data demonstrate that mutation scanning of the entire coding region of genes associated with Noonan syndrome is mandatory not to miss rare variants located outside the known mutational hotspots.
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Affiliation(s)
- Frederike L Harms
- Institute of Human Genetics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Malik Alawi
- University Medical Center Hamburg-Eppendorf, Bioinformatics Core Facility, Hamburg, Germany.,Center for Bioinformatics, University of Hamburg, Hamburg, Germany.,Heinrich-Pette-Institute, Leibniz-Institute for Experimental Virology, Virus Genomics, Hamburg, Germany
| | - David J Amor
- Murdoch Children's Research Institute, Parkville, Australia.,Department of Paediatrics, University of Melbourne, Parkville, Australia
| | - Tiong Y Tan
- Murdoch Children's Research Institute, Parkville, Australia.,Department of Paediatrics, University of Melbourne, Parkville, Australia
| | - Goran Cuturilo
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia.,University Children's Hospital, Belgrade, Serbia
| | - Christina Lissewski
- Institute of Human Genetics, University Hospital Magdeburg, Magdeburg, Germany
| | - Julia Brinkmann
- Institute of Human Genetics, University Hospital Magdeburg, Magdeburg, Germany
| | - Denny Schanze
- Institute of Human Genetics, University Hospital Magdeburg, Magdeburg, Germany
| | - Kerstin Kutsche
- Institute of Human Genetics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Martin Zenker
- Institute of Human Genetics, University Hospital Magdeburg, Magdeburg, Germany
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Cao H, Alrejaye N, Klein OD, Goodwin AF, Oberoi S. A review of craniofacial and dental findings of the RASopathies. Orthod Craniofac Res 2017; 20 Suppl 1:32-38. [PMID: 28643916 PMCID: PMC5942188 DOI: 10.1111/ocr.12144] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/23/2017] [Indexed: 02/05/2023]
Abstract
OBJECTIVES The RASopathies are a group of syndromes that have in common germline mutations in genes that encode components of the Ras/mitogen-activated protein kinase (MAPK) pathway and have been a focus of study to understand the role of this pathway in development and disease. These syndromes include Noonan syndrome (NS), Noonan syndrome with multiple lentigines (NSML or LEOPARD syndrome), neurofibromatosis type 1 (NF1), Costello syndrome (CS), cardio-facio-cutaneous (CFC) syndrome, neurofibromatosis type 1-like syndrome (NFLS or Legius syndrome) and capillary malformation-arteriovenous malformation syndrome (CM-AVM). These disorders affect multiple systems, including the craniofacial complex. Although the craniofacial features have been well described and can aid in clinical diagnosis, the dental phenotypes have not been analysed in detail for each of the RASopathies. In this review, we summarize the clinical features of the RASopathies, highlighting the reported craniofacial and dental findings. METHODS Review of the literature. RESULTS Each of the RASopathies reviewed, caused by mutations in genes that encode different proteins in the Ras pathway, have unique and overlapping craniofacial and dental characteristics. CONCLUSIONS Careful description of craniofacial and dental features of the RASopathies can provide information for dental clinicians treating these individuals and can also give insight into the role of Ras signalling in craniofacial development.
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Affiliation(s)
- Haotian Cao
- State Key Laboratory of Oral Diseases and Branch of Cleft Lip and Palate Surgery, Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
- Department of Orofacial Sciences and Program in Craniofacial Biology, University of California, San Francisco, San Francisco, CA, USA
| | - Najla Alrejaye
- Department of Orofacial Sciences and Program in Craniofacial Biology, University of California, San Francisco, San Francisco, CA, USA
| | - Ophir D. Klein
- Department of Orofacial Sciences and Program in Craniofacial Biology, University of California, San Francisco, San Francisco, CA, USA
- Department of Pediatrics and Institute for Medical Genetics, University of California, San Francisco, San Francisco, CA, USA
| | - Alice F. Goodwin
- Department of Orofacial Sciences and Program in Craniofacial Biology, University of California, San Francisco, San Francisco, CA, USA
| | - Snehlata Oberoi
- Department of Orofacial Sciences and Program in Craniofacial Biology, University of California, San Francisco, San Francisco, CA, USA
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12
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A progressively enlarging swelling in the mandible. Oral Surg Oral Med Oral Pathol Oral Radiol 2017; 123:283-287. [DOI: 10.1016/j.oooo.2016.04.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2016] [Revised: 04/06/2016] [Accepted: 04/18/2016] [Indexed: 01/10/2023]
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13
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Multifocal tenosynovial giant cell tumors in a child with Noonan syndrome. Pediatr Radiol 2017; 47:361-365. [PMID: 27878339 DOI: 10.1007/s00247-016-3743-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2016] [Revised: 09/28/2016] [Accepted: 10/27/2016] [Indexed: 10/20/2022]
Abstract
Noonan syndrome is a genetic disorder with variable expression of distinctive facial features, webbed neck, chest deformity, short stature, cryptorchidism and congenital heart disease. The association of Noonan syndrome and giant cell granulomas of the mandible is widely reported. However, Noonan syndrome may also be associated with single or multifocal tenosynovial giant cell tumors, also referred to as pigmented villonodular synovitis. We report a child with Noonan syndrome, giant cell granulomas of the mandible and synovial and tenosynovial giant cell tumors involving multiple joints and tendon sheaths who was initially misdiagnosed with juvenile idiopathic arthritis. It is important for radiologists to be aware of the association of Noonan syndrome and multifocal giant cell lesions, which can range from the more commonly described giant cell granulomas of the mandible to isolated or multifocal intra- or extra-articular tenosynovial giant cell tumors or a combination of all of these lesions.
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14
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van den Berg H, Schreuder WH, Jongmans M, van Bommel-Slee D, Witsenburg B, de Lange J. Multiple giant cell lesions in a patient with Noonan syndrome with multiple lentigines. Eur J Med Genet 2016; 59:425-8. [DOI: 10.1016/j.ejmg.2016.05.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2016] [Revised: 04/12/2016] [Accepted: 05/24/2016] [Indexed: 12/29/2022]
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Peacock JD, Dykema KJ, Toriello HV, Mooney MR, Scholten DJ, Winn ME, Borgman A, Duesbery NS, Hiemenga JA, Liu C, Campbell S, Nickoloff BP, Williams BO, Steensma M. Oculoectodermal syndrome is a mosaic RASopathy associated withKRASalterations. Am J Med Genet A 2015; 167:1429-35. [DOI: 10.1002/ajmg.a.37048] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2014] [Accepted: 02/18/2015] [Indexed: 12/20/2022]
Affiliation(s)
| | | | - Helga V. Toriello
- Michigan State University College of Human Medicine; Grand Rapids; Michigan
| | | | - Donald J. Scholten
- Van Andel Research Institute; Grand Rapids; Michigan
- Michigan State University College of Human Medicine; Grand Rapids; Michigan
| | - Mary E. Winn
- Van Andel Research Institute; Grand Rapids; Michigan
| | | | | | | | - Cong Liu
- Spectrum Health; Grand Rapids; Michigan
| | | | - Brian P. Nickoloff
- Van Andel Research Institute; Grand Rapids; Michigan
- Michigan State University College of Human Medicine; Grand Rapids; Michigan
| | | | - Matthew Steensma
- Van Andel Research Institute; Grand Rapids; Michigan
- Michigan State University College of Human Medicine; Grand Rapids; Michigan
- Spectrum Health; Grand Rapids; Michigan
- Helen DeVos Children's Hospital, Grand Rapids Michigan
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