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Pinto RB, Ramos ARL, Backes AN, dos Santos BJ, Provenzi VO, Carbonera MR, Roenick ML, dos Santos PPA, Falhauber F, de Souza MV, Bassols JV, Artigalás O. Hirschsprung disease and hepatoblastoma: case report of a rare association. SAO PAULO MED J 2016; 134:171-5. [PMID: 26465815 PMCID: PMC10496547 DOI: 10.1590/1516-3180.2014.9200311] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2014] [Revised: 07/07/2014] [Accepted: 11/03/2014] [Indexed: 01/01/2023] Open
Abstract
CONTEXT Hirschsprung disease is a developmental disorder of the enteric nervous system that is characterized by absence of ganglion cells in the distal intestine, and it occurs in approximately 1 in every 500,000 live births. Hepatoblastoma is a malignant liver neoplasm that usually occurs in children aged 6 months to 3 years, with a prevalence of 0.54 cases per 100,000. CASE REPORT A boy diagnosed with intestinal atresia in the first week of life progressed to a diagnosis of comorbid Hirschsprung disease. Congenital cataracts and sensorineural deafness were diagnosed. A liver mass developed and was subsequently confirmed to be a hepatoblastoma, which was treated by means of surgical resection of 70% of the liver volume and neoadjuvant chemotherapy (ifosfamide, cisplatin and doxorubicin). CONCLUSION It is known that Hirschsprung disease may be associated with syndromes predisposing towards cancer, and that hepatoblastoma may also be associated with certain congenital syndromes. However, co-occurrence of hepatoblastoma and Hirschsprung disease has not been previously described. We have reported a case of a male patient born with ileal atresia, Hirschsprung disease and bilateral congenital cataract who was later diagnosed with hepatoblastoma.
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Affiliation(s)
- Raquel Borges Pinto
- MD. Physician, Department of Pediatric Gastroenterology, Hospital da Criança Conceição, Grupo Hospitalar Conceição (GHC), Porto Alegre, Rio Grande do Sul, Brazil.
| | - Ana Regina Lima Ramos
- MD. Physician, Department of Pediatric Gastroenterology, Hospital da Criança Conceição, Grupo Hospitalar Conceição (GHC), Porto Alegre, Rio Grande do Sul, Brazil.
| | - Ariane Nadia Backes
- MD. Physician, Department of Pediatric Surgery, Hospital da Criança Conceição, Grupo Hospitalar Conceição (GHC), Porto Alegre, Rio Grande do Sul, Brazil.
| | - Beatriz John dos Santos
- MD. Physician, Department of Pediatric Gastroenterology, Hospital da Criança Conceição, Grupo Hospitalar Conceição (GHC), Porto Alegre, Rio Grande do Sul, Brazil.
| | - Valentina Oliveira Provenzi
- MD. Physician, Department of Pathological Anatomy, Hospital Nossa Senhora da Conceição, Grupo Hospitalar Conceição (GHC), Porto Alegre, Rio Grande do Sul, Brazil.
| | - Mário Rafael Carbonera
- MD. Physician, Department of Pediatric Surgery, Hospital da Criança Conceição, Grupo Hospitalar Conceição (GHC), Porto Alegre, Rio Grande do Sul, Brazil.
| | - Maria Lúcia Roenick
- MD. Resident, Department of Pediatric Surgery, Hospital da Criança Conceição, Grupo Hospitalar Conceição (GHC), Porto Alegre, Rio Grande do Sul, Brazil.
| | - Pedro Paulo Albino dos Santos
- MD. Physician, Department of Pediatric Oncology and Hematology, Hospital da Criança Conceição, Grupo Hospitalar Conceição (GHC), Porto Alegre, Rio Grande do Sul, Brazil.
| | - Fabrizia Falhauber
- MD. Physician, Department of Pediatric Oncology and Hematology, Hospital da Criança Conceição, Grupo Hospitalar Conceição (GHC), Porto Alegre, Rio Grande do Sul, Brazil.
| | - Meriene Viquetti de Souza
- MD. Resident, Department of Pediatrics, Hospital da Criança Conceição, Grupo Hospitalar Conceição (GHC), Porto Alegre, Rio Grande do Sul, Brazil.
| | - João Vicente Bassols
- MD. Physician, Department of Pediatric Surgery, Hospital da Criança Conceição, Grupo Hospitalar Conceição (GHC), Porto Alegre, Rio Grande do Sul, Brazil.
| | - Osvaldo Artigalás
- MD. Physician, Department of Medical Genetics, Hospital da Criança Conceição, Grupo Hospitalar Conceição (GHC), Porto Alegre, Rio Grande do Sul, Brazil.
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Pini Prato A, Rossi V, Mosconi M, Holm C, Lantieri F, Griseri P, Ceccherini I, Mavilio D, Jasonni V, Tuo G, Derchi M, Marasini M, Magnano G, Granata C, Ghiggeri G, Priolo E, Sposetti L, Porcu A, Buffa P, Mattioli G. A prospective observational study of associated anomalies in Hirschsprung's disease. Orphanet J Rare Dis 2013; 8:184. [PMID: 24267509 PMCID: PMC4222065 DOI: 10.1186/1750-1172-8-184] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2013] [Accepted: 11/21/2013] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Associated anomalies have been reported in around 20% of Hirschsprung patients but many Authors suggested a measure of underestimation. We therefore implemented a prospective observational study on 106 consecutive HSCR patients aimed at defining the percentage of associated anomalies and implementing a personalized and up-to-date diagnostic algorithm. METHODS After Institutional Ethical Committee approval, 106 consecutive Hirschsprung patients admitted to our Institution between January 2010 and December 2012 were included. All families were asked to sign a specific Informed Consent form and in case of acceptance each patient underwent an advanced diagnostic algorithm, including renal ultrasound scan (US), cardiologic assessment with cardiac US, cerebral US, audiometry, ENT and ophthalmologic assessments plus further specialist evaluations based on specific clinical features. RESULTS Male to female ratio of our series of patients was 3,4:1. Aganglionosis was confined to the rectosigmoid colon (classic forms) in 74,5% of cases. We detected 112 associated anomalies in 61 (57,5%) patients. The percentage did not significantly differ according to gender or length of aganglionosis. Overall, 43,4% of patients complained ophthalmologic issues (mostly refraction anomalies), 9,4% visual impairment, 20,7% congenital anomalies of the kidney and urinary tract, 4,7% congenital heart disease, 4,7% hearing impairment or deafness, 2,3% central nervous system anomalies, 8,5% chromosomal abnormalities or syndromes and 12,3% other associated anomalies. CONCLUSIONS Our study confirmed the underestimation of certain associated anomalies in Hirschsprung patients, such as hearing impairment and congenital anomalies of the kidney and urinary tract. Subsequently, based on our results we strongly suggest performing renal US and audiometry in all patients. Conversely, ophthalmologic assessment and cerebral and heart US can be performed according to guidelines applied to the general population or in case of patients with suspected clinical features or chromosomal abnormalities. This updated diagnostic algorithm aims at improving overall outcome thanks to better prognostic expectations, prevention strategies and early rehabilitation modalities. The investigation of genetic background of patients with associated anomalies might be the next step to explore this intriguing multifactorial congenital disease.
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Affiliation(s)
- Alessio Pini Prato
- Department of Pediatric Surgery, Istituto Giannina Gaslini, Largo G. Gaslini, 5, 16100 Genoa, Italy
| | - Valentina Rossi
- Department of Pediatric Surgery, Istituto Giannina Gaslini, Largo G. Gaslini, 5, 16100 Genoa, Italy
- DINOGMI, Università di Genova, Genova, Italy
| | - Manuela Mosconi
- Department of Pediatric Surgery, Istituto Giannina Gaslini, Largo G. Gaslini, 5, 16100 Genoa, Italy
| | - Catarina Holm
- Department of Pediatric Surgery, Istituto Giannina Gaslini, Largo G. Gaslini, 5, 16100 Genoa, Italy
| | - Francesca Lantieri
- Department of Health Science, Biostatistics Section, Università di Genova, Genova, Italy
| | - Paola Griseri
- UOC Medical Genetics, Istituto Giannina Gaslini, Genoa, Italy
| | | | - Domenico Mavilio
- Unit of Clinical and Experimental Immunology, Humanitas Clinical and Research Center, Rozzano, Milan, Italy
- Department of Medical Biotechnologies and Translational Medicine, University of Milan, Milan, Italy
| | - Vincenzo Jasonni
- Department of Pediatric Surgery, Istituto Giannina Gaslini, Largo G. Gaslini, 5, 16100 Genoa, Italy
| | - Giulia Tuo
- Cardiovascular Department, Istituto Giannina Gaslini, Genoa, Italy
| | - Maria Derchi
- Cardiovascular Department, Istituto Giannina Gaslini, Genoa, Italy
| | | | | | | | | | - Enrico Priolo
- Ophthalmology Unit, Istituto Giannina Gaslini, Genoa, Italy
| | | | - Adelina Porcu
- Otorhinolaryngology Unit, Giannina Gaslini Institute, Genoa, Italy
| | - Piero Buffa
- Department of Pediatric Surgery, Istituto Giannina Gaslini, Largo G. Gaslini, 5, 16100 Genoa, Italy
| | - Girolamo Mattioli
- Department of Pediatric Surgery, Istituto Giannina Gaslini, Largo G. Gaslini, 5, 16100 Genoa, Italy
- DINOGMI, Università di Genova, Genova, Italy
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Jaworek TJ, Bhatti R, Latief N, Khan SN, Riazuddin S, Ahmed ZM. USH1K, a novel locus for type I Usher syndrome, maps to chromosome 10p11.21-q21.1. J Hum Genet 2012; 57:633-7. [PMID: 22718019 PMCID: PMC3596105 DOI: 10.1038/jhg.2012.79] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
We ascertained two large Pakistani consanguineous families (PKDF231 and PKDF608) segregating profound hearing loss, vestibular dysfunction, and retinitis pigmentosa; the defining features of Usher syndrome type 1 (USH1). To date, seven USH1 loci have been reported. Here, we map a novel locus, USH1K, on chromosome 10p11.21-q21.1. In family PKDF231, we performed a genome-wide linkage screen and found a region of homozygosity shared among the affected individuals at chromosome 10p11.21-q21.1. Meiotic recombination events in family PKDF231 define a critical interval of 11.74 cM (20.20 Mb) bounded by markers D10S1780 (63.83 cM) and D10S546 (75.57 cM). Affected individuals of family PKDF608 were also homozygous for chromosome 10p11.21-q21.1-linked STR markers. Of the 85 genes within the linkage interval, PCDH15, GJD4, FZD4, RET and LRRC18 were sequenced in both families, but no potential pathogenic mutation was identified. The USH1K locus overlaps the non-syndromic deafness locus DFNB33 raising the possibility that the two disorders may be caused by allelic mutations.
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Affiliation(s)
- Thomas J Jaworek
- Division of Pediatric Ophthalmology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
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Spurrier JL, Weaver DD. Ramos-Arroyo syndrome: long-term follow-up of previously reported family. Am J Med Genet A 2008; 146A:675-82. [PMID: 18241069 DOI: 10.1002/ajmg.a.32203] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Here we report on a family with corneal anesthesia, absence of the peripapillary choriocapillaris and retinal pigment epithelium, bilateral sensorineural hearing loss, unusual facial appearance, persistent ductus arteriosus, Hirschsprung disease, and moderate mental retardation. The first two generations of this family were reported previously by Ramos-Arroyo et al. [Ramos-Arroyo et al., 1987]. Two further affected individuals have been born into this family and we have observed additional manifestations not previously reported that appear to be part of this syndrome. The differential diagnosis of the condition is also discussed. We think this is a distinct autosomal dominant syndrome with variable expressivity, and have named the disorder the Ramos-Arroyo syndrome.
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Affiliation(s)
- Jamie L Spurrier
- Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, Indiana, USA.
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