Gorlin's syndrome with associated odontogenic cysts

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 40-year study in the South African population

BACKGROUND

Nevoid basal cell carcinoma syndrome (NBCCS) is a hereditary autosomal dominant syndrome presenting with a number of signs and symptoms in different population groups.

METHODS

  The investigators implemented a 40-year retrospective analysis of the clinical and radiological features of South Africans affected by NBCCS presenting at the Departments of Oral Surgery, Pathology and Radiology of two major referral hospitals. Details of age, gender, ethnic origin, clinical, and radiological findings were recorded and compared to previous reports. A list of diagnostic criteria for diagnosis of NBCCS in this population was complied. Descriptive statistics were computed, and the P value was set at 0.05 or less.

RESULTS

The sample was composed of 15 patients. The mean age at the time of diagnosis was 22.7years (SD 20.9) with eight (53.3%) patients diagnosed before 20years of age (P=0.0001). The male: female ratio was 2:1. The most frequent major criteria were keratocystic odontogenic tumors (KCOTs) (100%), calcification of falx cerebri (40%), palmo-plantar pits (26.7%), and basal cell carcinomas (BCCs) (20%). The most frequent minor criteria were bifid ribs (20%), skull anomalies (20%), and hypertelorism (20%).

CONCLUSIONS

The results of this study indicate that there was a low frequency of falx cerebri calcifications, BCCs, skull, and rib anomalies in this sample compared to other population groups. These differences could be attributed to genetic, racial, and environmental factors. Future studies are needed to compile diagnostic criteria specific to different population groups.

Gorlin syndrome: two unusual cases of recurrent, bilateral, multinodular, calcified ovarian fibromas with conservative surgical treatment

Gynecologically, NBCCS is variously associated (14%-75% cases) to typically bilateral, multinodular, calcified, ovarian fibromas. We report 2 rare cases of unusually recurrent bilateral ovarian fibromas treated with conservative surgery. Preservation of the normal ovarian tissue is always recommended, even though there is the risk of recurrences, given the benign nature of the lesions and the young age of patients.

Correlation between imaging features and epithelial cell proliferation in keratocystic odontogenic tumour

OBJECTIVES

this study was undertaken to investigate the relationship between radiographic appearance and epithelial cell proliferations in keratocystic odontogenic tumours (KCOTs).

METHODS

a retrospective radiographic analysis was performed on 284 cases of KCOT to gain insight into the radiographic characteristics. Expression of Ki-67 in 30 of the 284 cases was detected by the labelled streptavidin-biotin (LSAB) method and evaluated by an image analysis system.

RESULTS

the radiographic presentation of KCOT was divided into four types: unilocular, multilocular, multiple and naevoid basal cell carcinoma syndrome (NBCCS). The expression of Ki-67 in NBCCS was significantly different from the solitary and multiple KCOTs (P = 0.018, 0.002). In multilocular KCOTs it was also significantly different from the unilocular and syndrome-associated lesions (P = 0.000). In contrast, no significant differences were observed between the solitary and multiple lesions (P = 0.220).

CONCLUSIONS

a high correlation exists in KCOT between its biological behaviour and imaging features. The solitary KCOT seems less biologically aggressive and it should be classified as a cyst rather than a tumour. This means that more than half of KCOTs manifest themselves as ordinary cysts.

Expression of basement membrane components in odontogenic cysts

OBJECTIVE

To compare the expression of basement membrane components (BMCs), including laminins 1 and 5, collagen type IV, and fibronectin in odontogenic keratocysts (OKCs) with dentigerous cysts (DCs) and radicular cysts (RCs).

MATERIALS AND METHODS

Basement membrane components were analysed in 20 OKCs, 20 DCs and 20 RCs using an immunohistochemical technique.

RESULTS

Odontogenic keratocysts, DCs and RCs showed positive reaction to all BMCs studied, with different distributions and intensity. OKCs showed continuous linear deposits for laminins 1 and 5 but two staining patterns (continuous and discontinuous) for collagen type IV and fibronectin. DCs exhibited continuous linear deposits for laminins 1 and 5 and collagen type IV but a discontinuous linear deposit for fibronectin. RCs displayed similar results to DCs for laminin 1, collagen type IV and fibronectin. Laminin 5 in RCs had two staining patterns. Constant results in all cysts were strong intensity for laminin 1 and moderate intensity for laminin 5.

CONCLUSIONS

Substantial differences in the expression of BMCs among studied cysts were not observed, suggesting that the separation of the epithelial lining in OKCs is not associated with the existence of these proteins.

Imaging modality correlations of an odontogenic keratocyst in the nevoid basal cell carcinoma syndrome: A family case report

Multiple maxillary and mandibular cysts are principle features of nevoid basal cell carcinoma syndrome (NBCCS; Gorlin-Goltz syndrome). We present a family case report of NBCCS with odontogenic keratocyst where the findings on plain films, CT, clinical, and histopathologic examinations are compared and analyzed. The systemic manifestations included frontal bossing, odontogenic keratocyst, ectopic calcification in 1 patient, and bifid rib in 1 patient. CT examination displayed aspects of bone morphology not visible on the plain films. Odontogenic keratocyst diagnosis was confirmed by histopathological examination. The features identified by these combined clinical, imaging, and histologic findings are helpful in identifying an NBCCS patient, distinguishing keratocyst from others cysts or neoplasic lesions, and can therefore influence surgical management. NBCCS is a rare autosomal dominant cancer predisposition syndrome, which is important to recognize when a patient has multiple odontogenic keratocysts, because lifelong monitoring is essential for patient management.

Nevoid basal cell carcinoma syndrome: a review of the literature and a report of a case

The purpose of this paper is to report the development of multiple odontogenic keratocysts (OKCs) in a 15-year-old female with nevoid basal cell carcinoma syndrome (NBCCS) and review the literature pertinent to NBCCS. Although more than 100 abnormalities have been reported in NBCCS, the development of OKCs is one of its principle features. In view of this, the patient was subjected to further medical, dermatological and radiographic investigation. Multiple basal cell naevi and skeletal anomalies associated with NBCCS were found. Because of the autosomal dominant inheritance of this syndrome, the patient's family was then investigated. The patient's father was found to have multiple OKCs. The report highlights the need for vigilance in considering the diagnosis of NBCCS in all cases of OKCs, particularly those affecting young patients.

Nevoid basal cell carcinoma syndrome: a review of the literature

The nevoid basal cell carcinoma syndrome (NBCCS) or Gorlin-Goltz Syndrome is an autosomal dominant disorder principally characterized by cutaneous basal cell carcinomas, multiple keratocysts, and skeletal anomalies. The present report reviews current knowledge of this disorder that has profound relevance to specialists in Oral and Maxillo-Facial Surgery, Oral Medicine and Radiology.

Odontogenic Keratocysts in Nevoid Basal Cell Carcinoma (Gorlin's) Syndrome: CT and MRI Evaluation

We describe the imaging findings in a 13-year-old boy with nevoid basal cell carcinoma syndrome (NBCCS). The initial imaging work-up included plain radiographs and computed tomography (CT) of the facial area and mandible. CT detected large expansile cystic changes on both sides of the body and angle of the mandible. When the patient's condition worsened, magnetic resonance imaging (MRI) was performed to further characterize the nature of the lesions and to rule out intracranial anomalies. We agree with others who have published previous reports that although CT is valuable in elucidating osseous craniofacial anomalies associated with NBCCS, MRI is superior in demonstrating the internal composition and structure of the odontogenic keratocysts that are commonly seen in this syndrome.

Gorlin's syndrome with a thin corpus callosum and a third ventricular cyst

Gorlin's syndrome (naevoid basal cell carcinoma) is an autosomal dominant tumor-predisposition syndrome, classically consists of multiple basal cell carcinomas of the skin, odontogenic keratocyst of the jaw, various skeletal abnormalities, and lamellar falx calcifications. Many associated lesions have been reported. We report a case of Gorlin's syndrome in a 22-year-old man in whom CT and MR images showed unusual findings of the thin corpus callosum and third ventricular cyst. We present a case of this syndrome with special emphasis on its unusual neuroradiological findings and radiological management.

Implant prosthodontic rehabilitation of a patient with nevoid basal cell carcinoma syndrome: a clinical report

This clinical report describes the prosthodontic rehabilitation of an edentulous patient with compromised maxillary and mandibular anatomy, caused by the resection of several odontogenic keratocysts associated with nevoid basal cell carcinoma syndrome. Preprosthetic surgical preparation included iliac crest bone grafting to both arches and placement of implants. Prosthodontic treatment included the fabrication of maxillary and mandibular dental implant-supported connecting bars and construction of attachment-retained overdentures.

Neuroradiological findings in a mother and daughter with Gorlin syndrome

A mother and daughter with Gorlin syndrome with similar neuroradiological findings are reported. These include calcification of the falx cerebri and tentorium cerebelli and dysgenesis of the corpus callosum and vermis. Vermian dysgenesis was detected in both mother and daughter suggesting a previously unrecognized finding associated with Gorlin syndrome.

The role of the orthodontist in the diagnosis of Gorlin's syndrome

Gorlin's syndrome is a relatively rare generalized disorder. Its diagnosis in childhood is usually through oral abnormalities. Some of the most frequent clinical features of this syndrome are discovered through radiographs commonly used in orthodontia. Thus, the orthodontist may be able to contribute to its diagnosis. The article shows three clinical cases that illustrate the role that the orthodontist may play in diagnosis of this syndrome.

Gorlin-Goltz: what's in a name?

This paper describes the clinical features of two very distinct syndromes with similar names: Gorlin-Goltz and Goltz-Gorlin Syndromes. A case report is presented that highlights the differences between these syndromes. To avoid errors in diagnosis because of the similarity in names, the authors caution that, based on additional information now available, the preferred names should be Focal Dermal Hypoplasia syndrome for Goltz-Gorlin syndrome and Nevoid Basal Cell Carcinoma syndrome for Gorlin-Goltz syndrome.

Otolaryngological manifestation of Gorlin Goltz syndrome

A 46-year-old Jordanian man was seen in ENT clinic complaining of progressive left nasal obstruction and hearing loss for the last five years with a history of multiple surgical removal of dental cysts. Clinical and radiological investigation revealed a cystic mass occupying the left maxillary sinus protruding to the nasal cavity, calcification of the falx cerebri and bifid ribs. On these findings Gorlin-Goltz syndrome was confirmed. The case is presented and the literature reviewed.