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Castillo-Tobar A, Urzúa B, Tirreau V, Donoso F, Pinares J, Cosmelli-Maturana R, Ortega-Pinto A. Clinical, radiographic, pathological and inherited characteristics of odontogenic keratocyst in nevoid basal cell carcinoma syndrome: a study in three Chilean families. Oral Radiol 2022:10.1007/s11282-022-00664-5. [DOI: 10.1007/s11282-022-00664-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Accepted: 11/09/2022] [Indexed: 11/29/2022]
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Chitta S, Patel J, Renapurkar S, Loschiavo C, Rhodes J, King K, Salkey K, Couser N. Nevoid basal cell carcinoma syndrome: a case report and literature review. Ophthalmic Genet 2021; 43:27-35. [PMID: 34608840 DOI: 10.1080/13816810.2021.1983847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND Nevoid basal cell carcinoma syndrome (NBCCS) is a rare genetic disorder associated with basal cell carcinomas (BCC), skeletal anomalies, and jaw cysts, and a number of ocular abnormalities. We describe a case of a 12-year-old boy diagnosed with NBCCS found to have several ophthalmic manifestations including a myelinated retinal nerve fiber. We conducted a literature review targeting the ocular and systemic manifestations of NBCCS, with a focus on the ophthalmic findings that have not been well characterized. MATERIALS AND METHODS We conducted a literature search from 1960 to 2021 utilizing specific keywords and criteria and excluded non-clinical articles. A total of 46 articles were ultimately used for the literature review. RESULTS In NBCCS, BCCs typically present before the age of 30 and gradually become numerous. Certain ocular features, less common in the general population, are much more common with NBCCS. Depending on the study, prevalence of these features in patients with NBCCS ranges from 26-80% for hypertelorism and 7-36% for myelinated retinal nerve fiber layer. Prevalence of nystagmus in patients with NBCCS was found to be approximately 6%. Systemic findings such as bilamellar calcification of the falx cerebri, palmar pits, and odontogenic keratocysts (OKCs) are also prevalent. CONCLUSION NBCCS may affect numerous organ systems, and thus requires a multidisciplinary team to manage. BCCs and jaw cysts are commonly occurring clinical features that have various surgical excisional options. The ocular anomalies of NBCCS are individually rare, and certain anomalies may present in the amblyogenic period of development and contribute to visual impairment.
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Affiliation(s)
- Shripadh Chitta
- Virginia Commonwealth University School of Medicine, Richmond, VA, USA
| | - Jineet Patel
- Virginia Commonwealth University School of Medicine, Richmond, VA, USA
| | - Shravan Renapurkar
- Department of Oral and Maxillofacial Surgery, Virginia Commonwealth University School of Dentistry, Richmond, VA, USA
| | - Christopher Loschiavo
- Department of Oral and Maxillofacial Surgery, Virginia Commonwealth University School of Dentistry, Richmond, VA, USA
| | - Jennifer Rhodes
- Craniofacial and Pediatric Plastic Surgery, Children's Hospital of Richmond at VCU, Richmond, VA, USA
| | - Kayla King
- Department of Human and Molecular Genetics, Virginia Commonwealth University Health System, Richmond, VA, USA
| | | | - Natario Couser
- Department of Human and Molecular Genetics, Virginia Commonwealth University Health System, Richmond, VA, USA.,Department of Ophthalmology, Virginia Commonwealth University School of Medicine, Richmond, VA, USA.,Department of Pediatrics, Virginia Commonwealth University School of Medicine, Children's Hospital of Richmond at VCU, Richmond, Richmond, VA, USA
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Saxena S, Sundaragiri KS, Bhargava A, Sankhla B. Studying the multiple faces of nevoid basal-cell carcinoma syndrome: A case series. J Oral Maxillofac Pathol 2020; 24:315-321. [PMID: 33456241 PMCID: PMC7802829 DOI: 10.4103/jomfp.jomfp_358_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2019] [Accepted: 06/03/2020] [Indexed: 11/23/2022] Open
Abstract
Nevoid basal-cell carcinoma syndrome (NBCCS) or Gorlin–Goltz syndrome is an autosomal dominant-inherited condition that exhibits high penetrance and variable expressivity; however, this disorder can arise spontaneously. In 1960, Gorlin and Goltz described the syndrome as a condition, comprising the principle triad of multiple basal cell carcinoma, odontogenic keratocysts, and skeletal anomalies. The diagnostic findings of NBCCS in four patients were studied and compared with other reports in the Indian population. Early diagnosis of this syndrome is important for counseling of patients to prevent the life-long complications of this syndrome which includes the malignancy, oro-maxillofacial deformation, and destruction; this may be reduced if the diagnosis and treatment are made feasible at the earliest.
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Affiliation(s)
- Shikha Saxena
- Department of Oral Pathology and Microbiology, RUHS College of Dental Sciences (Government Dental College and Hospital), Jaipur, Rajasthan, India
| | - Krishna Sireesha Sundaragiri
- Department of Oral Pathology and Microbiology, RUHS College of Dental Sciences (Government Dental College and Hospital), Jaipur, Rajasthan, India
| | - Akshay Bhargava
- Department of Oral Pathology and Microbiology, RUHS College of Dental Sciences (Government Dental College and Hospital), Jaipur, Rajasthan, India
| | - Bharat Sankhla
- Department of Oral Pathology and Microbiology, RUHS College of Dental Sciences (Government Dental College and Hospital), Jaipur, Rajasthan, India
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Multidisciplinary oral rehabilitation of an adolescent suffering from juvenile Gorlin-Goltz syndrome - a case report. Head Face Med 2019; 15:5. [PMID: 30736811 PMCID: PMC6367745 DOI: 10.1186/s13005-019-0189-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Accepted: 01/30/2019] [Indexed: 11/10/2022] Open
Abstract
Background The Gorlin-Goltz syndrome is an autosomal dominant disorder characterized by keratocystic odontogenic tumors in the jaws, multiple basal cell carcinomas and skeletal abnormities. Frequently, the manifestation of the syndrome occurs in the adolescent years. Case presentation An 11-year-old boy was referred to our clinic due to the persistence of the lower deciduous molars. The further diagnosis revealed bilateral keratocystic odontogenic tumors in the region of teeth 33 and 45 representing a symptom of a Gorlin-Goltz syndrome. This case of the oral rehabilitation of an adolescent with bilateral keratocystic odontogenic tumors shows the approach of a multidisciplinary treatment concept including the following elements: Enucleation and bone defect augmentation using a prefabricated bone graft; distraction osteogenesis to extend the graft-block vertically after cessation of growth; accompanying orthodontic treatment, guided implant placement and prosthetic rehabilitation. Six months after implant insertion, a new keratocystic odontogenic tumor in the basal part of the left sinus maxillaris had to be removed combined with the closure of the oroantral fistula. During the follow-up period of 18 months in semi-annual intervals, the patient showed no sign of pathology. Conclusion In the presented case could be shown that distraction osteogenesis of prefabricated bone blocks is possible. With a multidisciplinary approach in a long-term treatment a sufficient oral rehabilitation of the patient suffering from extended keratocystic odontogenic tumors was possible.
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Daroit NB, da Rocha Vieira R, Visioli F, Maito FDM, de Oliveira MG, Rados PV. Does Surgical Fragmentation of Odontogenic Keratocystic Capsule Interfere With the Recurrence Rate? J Oral Maxillofac Surg 2017; 76:770-774. [PMID: 29100832 DOI: 10.1016/j.joms.2017.09.022] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2017] [Revised: 09/29/2017] [Accepted: 09/29/2017] [Indexed: 10/18/2022]
Abstract
PURPOSE We hypothesized that fragmentation of the cystic capsule during surgery would influence the recurrence rate of odontogenic keratocysts (OKCs) regardless of the treatment modality chosen. MATERIALS AND METHODS We reviewed, in a retrospective study, cases diagnosed as OKCs on histopathologic examination at the oral pathology department between 1991 and 2013. Fragmentation data were obtained from the records of the oral surgical department. RESULTS Fragmentation of the capsules of OKCs during surgery did not affect recurrence, irrespective of the chosen treatment modality. The addition of techniques such as cryotherapy lowered the risk of recurrence of OKCs (P = .013) compared with after enucleation alone. Furthermore, patients with associated nevoid basal cell carcinoma syndrome had a greater recurrence rate than that of those with no associated syndrome (P = .033). CONCLUSIONS Fragmentation of the cystic capsule does not play an important role in the rate of OKC recurrence. The rate of recurrence can be modified by using additional strategies such as cryotherapy.
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Affiliation(s)
- Natália Batista Daroit
- PhD Student, Department of Oral Pathology, School of Dentistry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Rúbia da Rocha Vieira
- PhD Student, Department of Oral Pathology, School of Dentistry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Fernanda Visioli
- Professor, Department of Oral Pathology, School of Dentistry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Fabio Del Moro Maito
- Professor, Department of Oral Pathology, School of Dentistry, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, Brazil
| | - Márcia Gaiger de Oliveira
- Professor, Department of Oral Pathology, School of Dentistry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Pantelis Varvaki Rados
- Professor, Department of Oral Pathology, School of Dentistry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.
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Lata J, Verma N, Kaur A. Gorlin-Goltz syndrome: A case series of 5 patients in North Indian population with comparative analysis of literature. Contemp Clin Dent 2015; 6:S192-201. [PMID: 26604574 PMCID: PMC4632223 DOI: 10.4103/0976-237x.166813] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
Objective: In Indian scenario, Gorlin–Goltz syndrome (nevoid basal cell carcinoma syndrome [NBCCS]) has been rarely reported. The clinical, radiological, and histopathological findings and major and minor criteria in five cases of NBCCS in North Indian population have been presented along with a discussion of the role of gene mutation analysis in early diagnosis of syndrome. Materials and Methods: The diagnostic findings of Gorlin–Goltz syndrome in 5 patients were compared with other reports in Indian population and with reports of this syndrome in other parts of the world. Results: The most common features seen were keratocystic odontogenic tumors (100%), calcifications of falx cerebri (60%), palmar-plantar pits (80%), rib anomalies (80%), macroencephaly (60%), ocular hypertelorism (80%), and frontal bossing (60%) in our series. Retained deciduous teeth seen in 80% patients whose association has not been previously reported has been presented. None of our patients had basal cell carcinoma, syndactyly or polydactyly, pectus deformity, bridging of sella turcica, pigmented nevi, or family history of this syndrome in contrast to such findings in other Indian patients. Medulloblastoma has not been reported in any Indian patient so far compared to this finding in other studies conducted worldwide. Conclusions: Combining the features of 48 patients in 38 cases of NBCCS being published in Indian literature with five cases of our series and on comparison with other studies in the world, a wide disparity in different ethnic groups and a wide variation in presentation of syndrome within the same population is suggested.
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Affiliation(s)
- Jeevan Lata
- Department of Oral and Maxillofacial Surgery, Punjab Government Dental College and Hospital, Amritsar, Punjab, India
| | - Nitin Verma
- Department of Oral and Maxillofacial Surgery, Punjab Government Dental College and Hospital, Amritsar, Punjab, India
| | - Amandeep Kaur
- Department of Oral and Maxillofacial Surgery, Punjab Government Dental College and Hospital, Amritsar, Punjab, India
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MacDonald DS. A systematic review of the literature of nevoid basal cell carcinoma syndrome affecting East Asians and North Europeans. Oral Surg Oral Med Oral Pathol Oral Radiol 2015; 120:396-407. [PMID: 26297395 DOI: 10.1016/j.oooo.2015.05.024] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2015] [Revised: 05/06/2015] [Accepted: 05/29/2015] [Indexed: 12/28/2022]
Abstract
OBJECTIVE To compare, by systematic review, North European and East Asian consecutive case series of nevoid basal cell carcinoma syndrome (NBCCS). STUDY DESIGN A systematic review of the literature was performed for all consecutive case series of NBCCS, which included keratocystic odontgenic tumors (KCOTs) arising in North European and East Asian communities. The clinical and radiologically apparent features were identified and synthesized, and a meta-analysis was performed. RESULTS East Asian reports were significantly more "proband only" compared with North European reports. Significant differences between these 2 communities were observed for 5 of the 6 major features and 11 of the 27 minor features. With regard to the major NBCCS features, the North Europeans displayed significantly more frequent basal cell carcinomas, calcified falx cerebri, palmar and plantar pits, and a family history, whereas the East Asians displayed KCOTs significantly more frequently. With regard to minor features, East Asians displayed significantly more frequent cleft lips and palates and hypertelorism. CONCLUSIONS East Asians displayed multiple KCOTs and cleft lips and palates more frequently compared with North Europeans.
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Affiliation(s)
- David S MacDonald
- University of British Columbia, Chairman of the Division of Oral & Maxillofacial Radiology, Faculty of Dentistry, University of British Columbia, Vancouver, Canada.
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Conservative treatment protocol of keratocystic odontogenic tumor: report of a case with nevoid Basal cell carcinoma syndrome and literature review. J Maxillofac Oral Surg 2015; 14:475-81. [PMID: 25848161 DOI: 10.1007/s12663-014-0689-6] [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: 04/25/2014] [Accepted: 08/18/2014] [Indexed: 10/24/2022] Open
Abstract
Keratocystic odontogenic tumor (KOT) is one of the major components of nevoid basal cell carcinoma syndrome (NBCCS), which usually occurs in young ages and includes significant structures of jaws. According to high recurrence rate of KOT, there are many controversies in treatment of the lesion, especially in syndromic cases with younger ages. In current report, authors suggest a conservative protocol in the treatment of KOT in a patient with NBCCS.
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