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Tan AP, Priego G. Thanatophoric dysplasia type 1 with tectal plate dysplasia and aqueductal stenosis. Childs Nerv Syst 2019; 35:1059-1061. [PMID: 30610483 DOI: 10.1007/s00381-018-04035-6] [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: 09/16/2018] [Accepted: 12/17/2018] [Indexed: 10/27/2022]
Abstract
INTRODUCTION Skeletal dysplasias are a heterogeneous group of disorders comprising of more than 300 entities, many of which manifest in the prenatal period, emphasizing the importance of accurate prenatal diagnosis. Detection of a lethal skeletal dysplasia via prenatal ultrasound is often straightforward. However, establishing the specific diagnosis and detailed evaluation of intracranial anomalies are often challenging. Fetal magnetic resonance imaging (MRI) is superior to ultrasound in the detection of abnormal sulcation pattern, corpus callosal agenesis, and posterior fossa anomalies. Hence, it has the potential of delineating neuroimaging features that may not be fully elucidated by ultrasound. The objective of this article is to describe an unusual case of thanatophoric dysplasia (TD) with dysplastic tectal plate and resultant aqueductal stenosis diagnosed on fetal MRI. To the best of our knowledge, this has never been reported before in the literature. A comprehensive review of literature pertaining to TD-associated CNS abnormalities will also be included. CONCLUSIONS Our reported case adds to the current limited knowledge of this rare entity and emphasizes the crucial role of fetal MRI in expanding the neuroimaging phenotypes of TD.
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Affiliation(s)
- Ai Peng Tan
- Department of Diagnostic Imaging, National University Health System, 1E Kent Ridge Rd, Singapore, 119228, Singapore.
| | - Gema Priego
- Department of Radiology, Queen's Hospital, Rom Valley Way, Romford, RM7 0AG, UK
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Liao YM, Li SL, Luo GY, Wen HX, Ouyang SY, Chen CY, Yao Y, Bi JR, Tian XX. Routine screening for fetal limb abnormalities in the first trimester. Prenat Diagn 2015; 36:117-26. [PMID: 26573084 DOI: 10.1002/pd.4724] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2015] [Revised: 10/27/2015] [Accepted: 11/10/2015] [Indexed: 11/06/2022]
Affiliation(s)
- Yi-Mei Liao
- Department of Ultrasound; Shenzhen Maternity & Child Healthcare Hospital, Southern Medical University; Shenzhen Guangdong China
| | - Sheng-li Li
- Department of Ultrasound; Shenzhen Maternity & Child Healthcare Hospital, Southern Medical University; Shenzhen Guangdong China
| | - Guo-yang Luo
- Department of Obstetrics & Gynecology, School of Medicine; University of Connecticut; Farmington CT USA
| | - Hua-xuan Wen
- Department of Ultrasound; Shenzhen Maternity & Child Healthcare Hospital, Southern Medical University; Shenzhen Guangdong China
| | - Shu-yuan Ouyang
- Department of Central Laboratory, Shenzhen Maternity & Child Healthcare Hospital; Southern Medical University; Shenzhen Guangdong China
| | - Cong-ying Chen
- Department of Ultrasound; Shenzhen Maternity & Child Healthcare Hospital, Southern Medical University; Shenzhen Guangdong China
| | - Yuan Yao
- Department of Ultrasound; Shenzhen Maternity & Child Healthcare Hospital, Southern Medical University; Shenzhen Guangdong China
| | - Jing-ru Bi
- Department of Ultrasound; Shenzhen Maternity & Child Healthcare Hospital, Southern Medical University; Shenzhen Guangdong China
| | - Xiao-xian Tian
- Department of Ultrasound; Maternity & Child Healthcare Hospital of Guangxi Zhuang Autonomous Region; Nanning Guangxi China
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Zen PRG, Silva APD, O. Filho RL, Rosa RFM, Maia CR, Graziadio C, Paskulin GA. Diagnóstico pré-natal de displasia tanatofórica: papel do ultrassom fetal. REVISTA PAULISTA DE PEDIATRIA 2011. [DOI: 10.1590/s0103-05822011000300024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJETIVO: Relatar o caso de um paciente com displasia tanatofórica, uma forma autossômica dominante e letal de nanismo, diagnosticado ainda no período pré-natal, e revisar a literatura, discutindo os principais diagnósticos diferenciais e ressaltando a importância do ultrassom fetal na identificação de fetos portadores dessa displasia. DESCRIÇÃO DO CASO: O paciente é o segundo filho de pais jovens sem história familiar de doenças genéticas. O ultrassom fetal realizado com 35 semanas de gestação mostrou polidrâmnio, proeminência frontal e desproporção entre crânio e tronco, com hipoplasia torácica e encurtamento dos ossos longos, compatível com o diagnóstico de displasia tanatofórica. Ao nascimento, a criança era pequena e possuía hipotonia, macrocefalia, fontanelas amplas, hipoplasia de face média, olhos protrusos, hemangioma plano no nariz e pálpebras, nariz em sela, micrognatia, pescoço e tórax curtos e encurtamento importante de braços, antebraços, coxas e pernas. A avaliação radiográfica mostrou crânio com grande diâmetro transverso, tórax com costelas curtas e corpos vertebrais reduzidos, importante encurtamento e deformidade dos ossos longos dos membros superiores e inferiores (os fêmures eram curvos) e hipoplasia da bacia. Esses achados confirmaram o diagnóstico pré-natal de displasia tanatofórica. O paciente evoluiu para o óbito poucos dias após o nascimento devido à insuficiência respiratória. COMENTÁRIOS: A ultrassonografia fetal é um método não invasivo capaz de diagnosticar inúmeras displasias ósseas, incluindo a tanatofórica. A importância do diagnóstico intra-útero reside no fato de que auxilia no diagnóstico diferencial, e permite o aconselhamento genético à família.
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Giancotti A, Castori M, Spagnuolo A, Binni F, D'Ambrosio V, Pasquali G, Pizzuti A, Grammatico P. Early ultrasound suspect of thanatophoric dysplasia followed by first trimester molecular diagnosis. Am J Med Genet A 2011; 155A:1756-8. [PMID: 21671381 DOI: 10.1002/ajmg.a.34052] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2010] [Accepted: 03/22/2011] [Indexed: 11/06/2022]
Affiliation(s)
- Antonella Giancotti
- Department of Obstetrics and Gynecology, Sapienza University, Policlinico Umberto I Hospital, Rome, Italy
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Khalil A, Pajkrt E, Chitty LS. Early prenatal diagnosis of skeletal anomalies. Prenat Diagn 2011; 31:115-24. [DOI: 10.1002/pd.2676] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Delahaye S, Rosenblatt J, Costa JM, Bazin A, Bénifla JL, Jouannic JM. First-trimester molecular prenatal diagnosis of a thanatophoric dysplasia. Prenat Diagn 2010; 30:1222-3. [PMID: 20949643 DOI: 10.1002/pd.2638] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Bilardo CM, Timmerman E, Pajkrt E, van Maarle M. Increased nuchal translucency in euploid fetuses--what should we be telling the parents? Prenat Diagn 2010; 30:93-102. [PMID: 20077440 DOI: 10.1002/pd.2396] [Citation(s) in RCA: 71] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Nuchal translucency (NT) measurement between 11 and 14 weeks' gestation is an undisputed marker for aneuploidies. When conventional karyotyping is normal, enlarged NT is a strong marker for adverse pregnancy outcome, associated with miscarriage, intrauterine death, congenital heart defects, and numerous other structural defects and genetic syndromes. The risk of adverse outcome is proportional to the degree of NT enlargement. Although the majority of structural anomalies are amenable to ultrasound detection, unspecified genetic syndromes involving developmental delay may only emerge after birth. Concern over these prenatally undetectable conditions is a heavy burden for parents. However, following detection of enlarged NT the majority of babies with normal detailed ultrasound examination and echocardiography will have an uneventful outcome with no increased risk for developmental delay when compared to the general population. Counseling should emphasize this to help parents restore hope in normal pregnancy outcome and infant development.
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Affiliation(s)
- C M Bilardo
- Department of Obstetrics and Gynaecology, Fetal Medicine Unit Academic Medical Centre, Amsterdam, The Netherlands.
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Tonni G, Azzoni D, Ventura A, Ferrari B, Felice CD, Baldi M. Thanatophoric dysplasia type I associated with increased nuchal translucency in the first trimester: Early prenatal diagnosis using combined ultrasonography and molecular biology. Fetal Pediatr Pathol 2010; 29:314-22. [PMID: 20704477 DOI: 10.3109/15513811003796938] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
A case of thanatophoric dysplasia (TD) type I associated with severely increased nuchal translucency at first trimester screening for Down syndrome is reported. A 38-year-old woman, G2P1, with previous uneventful pregnancy, was referred for amniocentesis at 16 weeks due to positive first trimester integrated test. Amniocentesis revealed a 46,XX fetus. At 16 weeks gestation, the ultrasound examination of the fetus revealed a narrow chest, short ribs, and a generalized severe shortening of the long bones. The patient underwent a follow-up scan at 19 weeks which demonstrated ultrasound findings consistent with severe rhizomelic micromelia. A wide prenatal panel of gene mutations related with skeletal dysplasia was performed. Nucleotidic sequence using QF-PCR on exons 7,10, 15, 19 of the fibroblast growth factor receptor 3 (FGFR3) demonstrated a 742 C>T (R248C) mutation, which resulted in an Arg248Cys substitution in heterozygous state, leading to a prenatal diagnosis of thanatophoric dysplasia type I. The early diagnosis of this lethal form of skeletal dysplasia directed the prenatal counseling and allowed appropriate obstetric management. Necropsy, post-mortem x-ray, and histologic analysis of the growth plate might aid the diagnosis of TD type I.
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Affiliation(s)
- Gabriele Tonni
- Guastalla Civil Hospital, Department of Gynecology & Obstetrics, Guastalla, Italy
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Yamada T, Sawai H, Nishimura G, Numabe H, Cho K, Minakami H. Platyspondylic lethal skeletal dysplasia San Diego type (thanatophoric dysplasia type 1) associated with trisomy 21 presenting with nuchal translucency: a case report. Prenat Diagn 2009; 29:715-7. [PMID: 19340824 DOI: 10.1002/pd.2268] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Wong H, Kidd A, Zuccollo J, Tuohy J, Strand L, Tait J, Pringle K. A Case of Thanatophoric Dysplasia: The Early Prenatal 2D and 3D Sonographic Findings and Molecular Confirmation of Diagnosis. Fetal Diagn Ther 2008; 24:71-3. [DOI: 10.1159/000132411] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2007] [Accepted: 05/07/2007] [Indexed: 11/19/2022]
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Ngo C, Viot G, Aubry MC, Tsatsaris V, Grange G, Cabrol D, Pannier E. First-trimester ultrasound diagnosis of skeletal dysplasia associated with increased nuchal translucency thickness. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2007; 30:221-6. [PMID: 17582228 DOI: 10.1002/uog.4028] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
A series of five cases of skeletal dysplasia is reported in which the diagnosis was reached at the 11-14-week routine ultrasound examination in our referral center. All five cases had increased nuchal translucency thickness (NT) associated with bone abnormalities. We review the current literature on skeletal dysplasia in the first trimester of pregnancy associated with increased NT.
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Affiliation(s)
- C Ngo
- Department of Obstetrics and Gynaecology, Maternité Port-Royal, Paris, France
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Current awareness in prenatal diagnosis. Prenat Diagn 2005. [DOI: 10.1002/pd.1025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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