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Hamada M, Hida T, Idogawa M, Tange S, Kamiya T, Okura M, Yamashita T, Tokino T, Uhara H. Mosaic SUFU mutation associated with a mild phenotype of multiple hereditary infundibulocystic basal cell carcinoma syndrome. J Dermatol 2024. [PMID: 39158191 DOI: 10.1111/1346-8138.17434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2024] [Revised: 07/17/2024] [Accepted: 08/05/2024] [Indexed: 08/20/2024]
Abstract
Multiple hereditary infundibulocystic basal cell carcinoma syndrome (MHIBCC), an autosomal dominant disorder caused by variants in SUFU, is characterized by numerous infundibulocystic basal cell carcinomas (IBCCs). In this report, we present a possible case of mosaic MHIBCC. A 57-year-old woman underwent the removal of four papules on her face, which were diagnosed as IBCCs. Exome sequencing revealed a SUFU c.1022+1G>A mutation within the skin tumor. The same mutation was detected in her blood but at a lower allele frequency. TA cloning revealed that the allele frequency of the mutation in the blood was 0.07. Additionally, tumor assessment revealed loss of heterozygosity (LOH) in chromosome 10, including the SUFU locus. These results indicate the patient had mosaicism for the SUFU mutation in normal tissues, aligning with the mosaic MHIBCC diagnosis. This, combined with LOH, likely contributed to IBCC development. Mosaic MHIBCC may present with milder symptoms. However, it may still increase the risk of developing brain tumors and more aggressive basal cell carcinoma. The possibility of mosaicism should be investigated in mild MHIBCC cases, where standard genetic tests fail to detect SUFU germline variants.
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Affiliation(s)
- Marina Hamada
- Department of Dermatology, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Tokimasa Hida
- Department of Dermatology, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Masashi Idogawa
- Department of Medical Genome Sciences, Cancer Research Institute, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Shoichiro Tange
- Department of Medical Genome Sciences, Cancer Research Institute, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Takafumi Kamiya
- Department of Dermatology, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Masae Okura
- Department of Dermatology, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Toshiharu Yamashita
- Department of Dermatology, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Takashi Tokino
- Department of Medical Genome Sciences, Cancer Research Institute, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Hisashi Uhara
- Department of Dermatology, Sapporo Medical University School of Medicine, Sapporo, Japan
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2
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Goto K, Oishi T, Yoshikawa S. Carcinoid-Like Cell Arrangements in Basal Cell Carcinoma: A Study of 11 Cases. Int J Surg Pathol 2023; 31:1466-1472. [PMID: 36843540 DOI: 10.1177/10668969231157781] [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: 02/28/2023]
Abstract
Background. Carcinoid-like pattern in basal cell carcinoma is extremely rare and has only been documented in a textbook. The aim of this study is to reveal the characteristics of the carcinoid-like pattern in basal cell carcinoma as well as to establish the concept of the tumor pattern. Methods. Of 355 basal cell carcinoma cases (355 lesions of 308 patients), 11 tumors with histopathological features of carcinoid-like pattern were retrieved. Results. The patients included 5 males and 6 females with a median age of 73 years (range 38-86 years). Of the 11 lesions, 10 were observed on the head. Histopathologically, a carcinoid-like pattern with branching and anastomosing of trabecular structures was observed in 30% to 95% of the tumor area. No differentiation to sebocytes was observed in any of the tumors. The tumors were well-circumscribed, although 3 lesions contained an infiltrative-type component as well. The carcinoid-like pattern areas in all 11 lesions exhibited diffuse BerEP4 immunoexpression but no KIT, synaptophysin, or vimentin expression. Keratin 20-positive Merkel cells were not observed in the tumor areas. Conclusions. Basal cell carcinoma can show a carcinoid-like pattern cell arrangement. Based on the histopathological and immunohistochemical findings from our study, we collectively conclude that the carcinoid-like pattern in basal cell carcinoma does not seem to represent sebaceous mantle differentiation. Carcinoid-like pattern basal cell carcinoma can be distinguished from other tumors by the favorite site of the head, the co-existence of conventional basal cell carcinoma components, lack of sebaceous differentiation, and diffuse BerEP4 immunoexpression.
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Affiliation(s)
- Keisuke Goto
- Department of Diagnostic Pathology, Shizuoka Cancer Center Hospital, Sunto, Japan
- Department of Pathology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
- Department of Pathology, Tokyo Metropolitan Cancer and Infectious Disease Center Komagome Hospital, Tokyo, Japan
- Department of Pathology, Itabashi Central Clinical Laboratory, Tokyo, Japan
- Department of Anatomic Pathology, Tokyo Medical University, Tokyo, Japan
- Department of Diagnostic Pathology, Chutoen General Medical Center, Kakegawa, Japan
- Department of Diagnostic Pathology and Cytology, Osaka International Cancer Institute, Osaka, Japan
- Department of Clinical Laboratory and Diagnostic Pathology, Osaka National Hospital, Osaka, Japan
- Department of Dermatology, Hyogo Cancer Center, Akashi, Japan
- Department of Dermato-Oncology/Dermatology, National Hospital Organization Kagoshima Medical Center, Kagoshima, Japan
| | - Takuma Oishi
- Department of Diagnostic Pathology, Shizuoka Cancer Center Hospital, Sunto, Japan
| | - Shusuke Yoshikawa
- Department of Dermatology, Shizuoka Cancer Center Hospital, Sunto, Japan
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3
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Petrosian D, Reiter P, Rozenberg SS, Petrosian S. A case of Gorlin syndrome like phenotype with multiple infundibulocystic basal cell carcinomas in a moniliform blepharosis arrangement. JAAD Case Rep 2023; 34:27-31. [PMID: 36941877 PMCID: PMC10023862 DOI: 10.1016/j.jdcr.2023.01.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/13/2023] Open
Affiliation(s)
- David Petrosian
- Department of Family Medicine, St. John’s Episcopal Hospital, Far Rockaway, New York
- Correspondence to: David Petrosian, DO, 6515 Alderton St, Apt 2A, Rego Park, NY 11374.
| | - Paloma Reiter
- Department of Dermatology, St. John’s Episcopal Hospital, Far Rockaway, New York
| | | | - Sergey Petrosian
- Ronald O. Perelman Department of Dermatology, New York University School of Medicine, New York, New York
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Álvarez-Salafranca M, García-García M, Montes-Torres A, Rivera-Fuertes I, López-Giménez MT, Ara M. SUFU-associated Gorlin syndrome: Expanding the spectrum between classic nevoid basal cell carcinoma syndrome and multiple hereditary infundibulocystic basal cell carcinoma. Australas J Dermatol 2023; 64:249-254. [PMID: 36825822 DOI: 10.1111/ajd.14014] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Accepted: 02/11/2023] [Indexed: 02/25/2023]
Abstract
Basal cell nevus syndrome (BCNS), also known as Gorlin syndrome, is characterized by an aberrant activation of the hedgehog (Hh) pathway, most cases being caused by PTCH1 mutations. However, certain features such as multiple hereditary infundibulocystic basal cell carcinomas (MHIBCC), sclerotic fibromas, childhood medulloblastoma or meningioma may be relatively specific to a SUFU mutation. We present two patients with MHIBCC, along with a more complex cutaneous and extracutaneous phenotype. MHIBCC syndrome and BCNS may share clinical features and, indeed, both syndromes probably represent different degrees of upregulation in the Hh pathway.
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Affiliation(s)
| | - Mar García-García
- Department of Pathology, Hospital Clínico Universitario "Lozano Blesa", Zaragoza, Spain
| | - Andrea Montes-Torres
- Department of Dermatology, Hospital Clínico Universitario "Lozano Blesa", Zaragoza, Spain
| | - Ignacio Rivera-Fuertes
- Department of Dermatology, Hospital Clínico Universitario "Lozano Blesa", Zaragoza, Spain
| | | | - Mariano Ara
- Department of Dermatology, Hospital Clínico Universitario "Lozano Blesa", Zaragoza, Spain
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5
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Nguyen CV, Rubin AI, Smith A, Castelo-Soccio L. Retrospective analysis of the histopathologic features of basal cell carcinomas in pediatric patients with basal cell nevus syndrome. J Cutan Pathol 2020; 48:390-395. [PMID: 33063358 DOI: 10.1111/cup.13899] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 10/09/2020] [Accepted: 10/11/2020] [Indexed: 12/13/2022]
Abstract
Basal cell nevus syndrome (BCNS) is an autosomal dominant condition caused most often by a loss-of-function mutation in the Patched-1 (PTCH1) gene. It is characterized by the development of varied benign and malignant tumors, including numerous cutaneous basal cell carcinomas (BCCs). The PTCH1 gene is integral in hair follicle development and loss of function mutation may lead to BCCs with an infundibulocystic histopathology in BCNS patients. Few studies have described the histopathological features of BCCs in BCNS. The recognition of these histopathologic features by dermatologists, dermatopathologists, and others caring for children will allow earlier and more effective identification of BCNS. We performed a retrospective analysis of 25 BCCs in 11 patients aged 5 to 19 years with BCNS and evaluated the histopathologic features on hematoxylin-eosin-stained sections. Our study found that 80% of BCCs in BCNS patients occurred on the head and neck with 64% of the specimens demonstrating infundibulocystic differentiation. Infundibulocystic differentiation is a common finding in BCCs found in BCNS. The finding of cutaneous neoplasms consistent with BCC with infundibulocystic differentiation in children is common in pediatric patients with BCNS and can be considered to be an early marker of the disorder, prompting further clinical investigation.
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Affiliation(s)
- Cuong V Nguyen
- Department of Dermatology and Dermatopathology, Northwestern University, Feinberg School of Medicine, Chicago, Illinois, USA
| | - Adam I Rubin
- Department of Pediatrics, Section of Dermatology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.,Department of Dermatology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA.,Department of Pathology and Laboratory Medicine, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.,Perlman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Anna Smith
- Department of Pediatrics, Section of Dermatology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Leslie Castelo-Soccio
- Department of Pediatrics, Section of Dermatology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.,Perlman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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6
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Sun Q, Atzmony L, Zaki T, Peng A, Sugarman J, Choate KA. Clues to primary vismodegib resistance lie in histology and genetics. J Clin Pathol 2020; 73:678-680. [PMID: 32217615 PMCID: PMC7513245 DOI: 10.1136/jclinpath-2020-206448] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Revised: 02/17/2020] [Accepted: 03/08/2020] [Indexed: 01/08/2023]
Abstract
Basal cell carcinoma (BCC) is the most common human malignant neoplasm. However, there are multiple BCC subtypes that share clinical features while demanding different management. We present a case of a woman with hundreds of BCCs throughout her body that were resistant to vismodegib and without other features of basal cell nevus syndrome. Histological results of biopsies taken from various sites revealed three lesions characteristic of infundibulocystic BCCs (IBCCs) and two BCCs. Paired whole-exome sequencing performed using DNA isolated from blood and one of her IBCCs uncovered a germline heterozygous SUFU (Suppressor of Fused) mutation. The downstream location of SUFU in the hedgehog pathway explains why its mutation results in IBCCs that will not respond to any therapeutics that target upstream components of SUFU. These results capture the significance of histological and genetic analysis in directing treatment.
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Affiliation(s)
- Qisi Sun
- Department of Dermatology, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Lihi Atzmony
- Department of Dermatology, Yale University School of Medicine, New Haven, Connecticut, USA.,Department of Genetics, Yale University School of Medicine, New Haven, Connecticut, USA.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Theodore Zaki
- Department of Dermatology, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Albert Peng
- Redwood Family Dermatology, Santa Rosa, California, USA
| | - Jeffrey Sugarman
- Department of Family Medicine, University of California San Francisco School of Medicine, San Francisco, California, USA.,Department of Dermatology, University of California San Francisco School of Medicine, San Francisco, California, USA
| | - Keith A Choate
- Department of Dermatology, Yale University School of Medicine, New Haven, Connecticut, USA .,Department of Genetics, Yale University School of Medicine, New Haven, Connecticut, USA.,Department of Pathology, Yale University School of Medicine, New Haven, CT, United States
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Agustí Martínez J, Bella-Navarro R, García-García AB, Bueno E, González-Sarmiento R, Navarro L, Sanchez-Sendra B, Revert A, Jordá E, Monteagudo C. Familial seborrhoeic keratosis associated with multiple 'pure reticulated acanthomas' and infundibulocystic basal cell carcinomas. Br J Dermatol 2017. [PMID: 28627087 DOI: 10.1111/bjd.15736] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
BACKGROUND A variety of genodermatoses with multiple cutaneous tumours and germline genetic alterations, such as PTCH1 mutations, have been described. Other cutaneous syndromes have been associated with somatic gene mutations, such as FGFR3 in familial seborrhoeic keratosis. OBJECTIVES To describe the clinical, dermoscopic and histopathological features of multiple cutaneous lesions, mostly infundibulocystic basal cell carcinomas (ICBCCs) and pure reticulated acanthomas, present in a family affected by familial seborrhoeic keratosis. In addition, we tested for possible germline alterations in FGFR3 and PTCH1. METHODS Ten members of one family were clinically examined and 92 skin biopsy specimens were evaluated. Blood samples from six individuals were analysed for FGFR3 and PTCH1 germline alterations. We reviewed the literature concerning genetic FGFR3 alterations in seborrhoeic keratosis. RESULTS Individuals of all generations affected by familial seborrhoeic keratosis also presented other skin tumours that corresponded histologically to reticulated acanthomas without apocrine or sebaceous differentiation, as well as ICBCCs. In addition, two novel germline variants, p.Pro449Ser (c.1345C>T) in FGFR3 and p.Pro725Ser (c.2173C>T) in exon 14 of PTCH1 were identified in five participants. CONCLUSIONS We characterize for the first time the clinical, dermoscopic and histopathological features of multiple reticulated acanthomas without apocrine or sebaceous differentiation, for which we propose the term 'pure reticulated acanthoma', and ICBCCs associated with familial seborrhoeic keratosis. We identified FGFR3 and PTCH1 germline polymorphisms whose influence in the development of reticulated acanthomas is unknown.
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Affiliation(s)
- J Agustí Martínez
- Department of Pathology, Hospital Clínico Universitario-INCLIVA, University of Valencia, Valencia, Spain.,Department of Pathology, Consorcio Hospitalario Provincial of Castellón, Valencia, Spain
| | - R Bella-Navarro
- Department of Dermatology, Hospital Clínico Universitario-INCLIVA, University of Valencia, Valencia, Spain
| | - A B García-García
- Genetic Diagnosis Unit, Hospital Clínico Universitario-INCLIVA, University of Valencia, Valencia, Spain
| | - E Bueno
- Department of Molecular Medicine, University of Salamanca, Salamanca, Spain
| | | | - L Navarro
- Department of Pathology, Hospital Clínico Universitario-INCLIVA, University of Valencia, Valencia, Spain
| | - B Sanchez-Sendra
- Department of Pathology, Hospital Clínico Universitario-INCLIVA, University of Valencia, Valencia, Spain
| | - A Revert
- Department of Dermatology, Hospital Clínico Universitario-INCLIVA, University of Valencia, Valencia, Spain
| | - E Jordá
- Department of Dermatology, Hospital Clínico Universitario-INCLIVA, University of Valencia, Valencia, Spain
| | - C Monteagudo
- Department of Pathology, Hospital Clínico Universitario-INCLIVA, University of Valencia, Valencia, Spain
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8
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Abstract
Basal cell carcinomas are the most common primary cutaneous malignant neoplasms. The diagnosis of basal cell carcinoma represents a common and routine task for pathologists and dermatopathologists. The aim of this review is the clinical and histopathological presentation of the most common subtypes of basal cell carcinoma. Furthermore, the rare variants of basal cell carcinoma and their differential diagnoses are also discussed.
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Affiliation(s)
- J Liersch
- Dermatopathologie Duisburg, An der Abtei 7-11, 47166, Duisburg, Deutschland
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9
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Prieto-Granada C, Rodriguez-Waitkus P. Basal cell carcinoma: Epidemiology, clinical and histologic features, and basic science overview. Curr Probl Cancer 2015; 39:198-205. [PMID: 26239203 DOI: 10.1016/j.currproblcancer.2015.07.004] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
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10
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Li Q, Gao T, Long HA, Ujiie H. Clearance of a Thick Invasive Squamous Cell Carcinoma After Multiple Treatments with Topical Photodynamic Therapy. Photomed Laser Surg 2010; 28:703-6. [PMID: 20961235 DOI: 10.1089/pho.2009.2610] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Qiang Li
- Department of Dermatology, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Tianwen Gao
- Department of Dermatology, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Heather Ann Long
- Department of Dermatology, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Hideyuki Ujiie
- Department of Dermatology, Hokkaido University Graduate School of Medicine, Sapporo, Japan
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Haykal S, Al Habeeb AS, Goldstein DP, Murray CA, Ghazarian D. Infundibular carcinoma of the skin: a distinct morphological and immunohistochemical entity. J Clin Pathol 2010; 63:455-62. [DOI: 10.1136/jcp.2009.074419] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
This report describes a new entity which has been defined as infundibular carcinoma (IC) of the skin. This new entity must be distinguished from other basaloid carcinomas arising from the epidermis, the hair follicles or from sweat duct and glandular elements. Specific criteria have been used to define ICs. These include the macroscopic and the microscopic site of the tumour as well as its histomorphological and immunohistochemical patterns. A brief review of benign and malignant tumours of the pilar unit and the differential diagnosis of IC is also provided.
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12
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Ryu DJ, Kwon YS, Roh MR, Lee MG. Two Cases of Nevoid Basal Cell CarcinomaSyndrome in One Family. Ann Dermatol 2008; 20:221-5. [PMID: 27303197 DOI: 10.5021/ad.2008.20.4.221] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2007] [Accepted: 05/22/2008] [Indexed: 11/08/2022] Open
Abstract
The nevoid basal cell carcinoma syndrome, or Gorlin-Goltz syndrome, is an autosomal dominant multiple system disorder with high penetrance and variable expressions, although it can also arise spontaneously. The diagnostic criteria for nevoid basal cell carcinoma syndrome include multiple basal cell carcinomas, palmoplantar pits, multiple odontogenic keratocysts, skeletal anomalies, positive family history, ectopic calcification and neurological anomalies. We report a brother and sister who were both diagnosed with nevoid basal cell carcinoma syndrome.
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Affiliation(s)
- Dong Jin Ryu
- Department of Dermatology and Cutaneous Biology Research Institute,Yonsei University College of Medicine, Seoul, Korea
| | - Yeon Sook Kwon
- Department of Dermatology and Cutaneous Biology Research Institute,Yonsei University College of Medicine, Seoul, Korea
| | - Mi Ryung Roh
- Department of Dermatology and Cutaneous Biology Research Institute,Yonsei University College of Medicine, Seoul, Korea
| | - Min Geol Lee
- Department of Dermatology and Cutaneous Biology Research Institute,Yonsei University College of Medicine, Seoul, Korea
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