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Antal G, Zsigmond A, Till Á, Orsi E, Szanto I, Büki G, Kereskai L, Herbert Z, Hadzsiev K, Bene J. Case report: Initial atypical skeletal symptoms and dental anomalies as first signs of Gardner syndrome: the importance of genetic analysis in the early diagnosis. Pathol Oncol Res 2024; 30:1611768. [PMID: 38807857 PMCID: PMC11130347 DOI: 10.3389/pore.2024.1611768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2024] [Accepted: 04/29/2024] [Indexed: 05/30/2024]
Abstract
Background: Gardner syndrome is a rare genetic cancer predisposition disorder characterized by intestinal polyposis, multiple osteomas, and soft and hard tissue tumors. Dental anomalies are present in approximately 30%-70% of patients with Gardner syndrome and can be discovered during routine dental examinations. However, sometimes the diagnosis is challenging due to the high clinical variability and incomplete clinical picture. Herein, we report a family with various dental and bone anomalies, in which the definitive diagnosis was established with the help of a comprehensive genetic analysis based on state-of-the-art next-generation sequencing technology. Case presentation: A 17-year-old female index patient presented with dental (caries, impacted, retained and anteriorly located teeth) and atypical bone anomalies not resembling Gardner syndrome. She was first referred to our Genetic Counselling Unit at the age of 11 due to an atypical bone abnormality identified by a panoramic X-ray. Tooth 3.6 was surgically removed and the histopathology report revealed a Paget's disease-like bone metabolic disorder with mixed osteoblastic and osteoclastic activity of the mandible. A small lumbar subcutaneous tumor was discovered by physical examination. Ultrasound examination of the tumor raised the possibility of a soft tissue propagation of chondromatosis. Her sister, 2 years younger at the age of 14, had some benign tumors (multiple exostoses, odontomas, epidermoid cysts) and impacted teeth. Their mother had also skeletal symptoms. Her lower teeth did not develop, the 9th-10th ribs were fused, and she complained of intermittent jaw pain. A cranial CT scan showed fibrous dysplasia on the cranial bones. Whole exome sequencing identified a heterozygous pathogenic nonsense mutation (c.4700C>G; p.Ser1567*) in the APC gene in the index patient's DNA. Targeted sequencing revealed the same variant in the DNA of the other affected family members (the sister and the mother). Conclusion: Early diagnosis of this rare, genetically determined syndrome is very important, because of the potentially high malignant transformation of intestinal polyps. Dentists should be familiar with the typical maxillofacial features of this disorder, to be able to refer patients to genetic counseling. Dental anomalies often precede the intestinal polyposis and facilitate the early diagnosis, thereby increasing the patients' chances of survival. Genetic analysis may be necessary in patients with atypical phenotypic signs.
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Affiliation(s)
- Gréta Antal
- Department of Dentistry, Oral and Maxillofacial Surgery, Clinical Center, Medical School, University of Pécs, Pécs, Hungary
| | - Anna Zsigmond
- Department of Medical Genetics, Clinical Center, Medical School, University of Pécs, Pécs, Hungary
| | - Ágnes Till
- Department of Medical Genetics, Clinical Center, Medical School, University of Pécs, Pécs, Hungary
| | - Eniko Orsi
- Department of Dentistry, Oral and Maxillofacial Surgery, Clinical Center, Medical School, University of Pécs, Pécs, Hungary
| | - Ildiko Szanto
- Department of Dentistry, Oral and Maxillofacial Surgery, Clinical Center, Medical School, University of Pécs, Pécs, Hungary
| | - Gergely Büki
- Department of Medical Genetics, Clinical Center, Medical School, University of Pécs, Pécs, Hungary
| | - László Kereskai
- Department of Pathology, Clinical Center, Medical School, University of Pécs, Pécs, Hungary
| | - Zsuzsanna Herbert
- Department of Medical Imaging, Clinical Center, Medical School, University of Pécs, Pécs, Hungary
| | - Kinga Hadzsiev
- Department of Medical Genetics, Clinical Center, Medical School, University of Pécs, Pécs, Hungary
| | - Judit Bene
- Department of Medical Genetics, Clinical Center, Medical School, University of Pécs, Pécs, Hungary
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2
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Olaopa OI, Dada AA, Soneye OY, Iyapo O, Akinniyi TA, Adisa AO, Kanmodi KK, Olaopa AO, Emeka CI, Ehanire ID, Coker MO. A rare case of Gardner syndrome in an African adult male: A case report. Clin Case Rep 2024; 12:e8735. [PMID: 38576527 PMCID: PMC10991715 DOI: 10.1002/ccr3.8735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2024] [Revised: 03/08/2024] [Accepted: 03/19/2024] [Indexed: 04/06/2024] Open
Abstract
Gardner's syndrome with the complete manifestation of colonic and extracolonic features is uncommon. Therefore, every clinician should view extracolonic features with a high index of suspicion. This may be key to early diagnosis, definitive management in these patients and importantly, helps prevent malignant transformation of existing colonic polyps.
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Affiliation(s)
- Olusegun I. Olaopa
- Department of Dental ServicesFederal Medical Centre, Ebute‐MettaLagosLagos StateNigeria
| | - Adedamola A. Dada
- Department of SurgeryFederal Medical Centre, Ebute‐MettaLagosLagos StateNigeria
| | | | - Oluwadamilare Iyapo
- Department of Pathologic ServicesFederal Medical Centre, Ebute‐MettaLagosLagos StateNigeria
| | - Taofeek A. Akinniyi
- Department of Oral and Maxillofacial SurgeryObafemi Awolowo University Teaching Hospitals ComplexIle‐IfeOsun StateNigeria
| | - Akinyele O. Adisa
- Department of Oral PathologyCollege of Medicine, University of IbadanIbadanOyo StateNigeria
| | - Kehinde K. Kanmodi
- School of DentistryUniversity of RwandaKigaliRwanda
- Faculty of DentistryUniversity of PuthisastraPhnom PenhCambodia
| | | | - Christian I. Emeka
- Department of Dental ServicesFederal Medical Centre, Ebute‐MettaLagosLagos StateNigeria
| | - Imudia D. Ehanire
- Department of SurgeryFederal Medical Centre, Ebute‐MettaLagosLagos StateNigeria
| | - Modupe O. Coker
- Department of Oral BiologyRutgers School of Dental MedicineNewarkNew JerseyUSA
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3
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Rosen AS, Sarmiento HL, Rosen PS, Peters SM. Multifocal mixed radiolucent-radiopaque lesions in an adult. J Am Dent Assoc 2024; 155:184-188. [PMID: 36543654 DOI: 10.1016/j.adaj.2022.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 10/31/2022] [Accepted: 11/01/2022] [Indexed: 12/24/2022]
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Dabbas WF, Hiasat MY, Ibrahim B, Allababede R, Alkhaldi TA, Al Warawrah A, Nadi M. A Report of Two Simultaneous Different Skull Vault Boney Pathologies: An Extremely Rare Clinical Scenario. Cureus 2023; 15:e40248. [PMID: 37440816 PMCID: PMC10334685 DOI: 10.7759/cureus.40248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/10/2023] [Indexed: 07/15/2023] Open
Abstract
Primary calvarial boney tumors are generally rare in clinical practice. Multiple primary skull neoplasms are less frequent, typically associated with genetic disorders or familial syndromes. Sporadic cases of multiple skull tumors are exceptionally rare. We present a unique scenario of a 32-year-old female patient who had two right-sided skull vault lesions, one located over the right parietal area and the other in the right retro-auricular region. The lesions exhibited different behaviors over several years. The workup revealed that the two skull lesions were of two pathologies. The standard academic approach for clinical analysis attributes the symptoms often to one pathological process until proven otherwise. This case highlights the significance of expanding the differential diagnoses and incites clinicians to consider multiple pathologies in specific clinical settings.
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Affiliation(s)
- Waleed F Dabbas
- Division of Neurosurgery, Department of Special Surgery, Faculty of Medicine, Al-Balqa Applied University, Al-Salt, JOR
| | | | - Bilal Ibrahim
- Division of Neurosurgery, Department of Special Surgery, Faculty of Medicine, Al-Balqa Applied University, Al-Salt, JOR
| | - Razan Allababede
- Division of Neurosurgery, Department of Special Surgery, Faculty of Medicine, Al-Balqa Applied University, Al-Salt, JOR
| | - Tareq A Alkhaldi
- Division of Neurosurgery, Department of Special Surgery, Faculty of Medicine, Al-Balqa Applied University, Al-Salt, JOR
| | - Ayah Al Warawrah
- Division of Neurosurgery, Department of Special Surgery, Faculty of Medicine, Al-Balqa Applied University, Al-Salt, JOR
| | - Mustafa Nadi
- Division of Neurosurgery, Department of Special Surgery, Faculty of Medicine, Al-Balqa Applied University, Al-Salt, JOR
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5
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Zhang H, Gong X, Xu X, Wang X, Sun Y. Tooth number abnormality: from bench to bedside. Int J Oral Sci 2023; 15:5. [PMID: 36604408 PMCID: PMC9816303 DOI: 10.1038/s41368-022-00208-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 09/24/2022] [Accepted: 11/01/2022] [Indexed: 01/07/2023] Open
Abstract
Tooth number abnormality is one of the most common dental developmental diseases, which includes both tooth agenesis and supernumerary teeth. Tooth development is regulated by numerous developmental signals, such as the well-known Wnt, BMP, FGF, Shh and Eda pathways, which mediate the ongoing complex interactions between epithelium and mesenchyme. Abnormal expression of these crutial signalling during this process may eventually lead to the development of anomalies in tooth number; however, the underlying mechanisms remain elusive. In this review, we summarized the major process of tooth development, the latest progress of mechanism studies and newly reported clinical investigations of tooth number abnormality. In addition, potential treatment approaches for tooth number abnormality based on developmental biology are also discussed. This review not only provides a reference for the diagnosis and treatment of tooth number abnormality in clinical practice but also facilitates the translation of basic research to the clinical application.
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Affiliation(s)
- Han Zhang
- grid.24516.340000000123704535Department of Implantology, Stomatological Hospital and Dental School of Tongji University, Shanghai Engineering Research Center of Tooth Restoration and Regeneration, Shanghai, China
| | - Xuyan Gong
- grid.24516.340000000123704535Department of Implantology, Stomatological Hospital and Dental School of Tongji University, Shanghai Engineering Research Center of Tooth Restoration and Regeneration, Shanghai, China
| | - Xiaoqiao Xu
- grid.24516.340000000123704535Department of Implantology, Stomatological Hospital and Dental School of Tongji University, Shanghai Engineering Research Center of Tooth Restoration and Regeneration, Shanghai, China
| | - Xiaogang Wang
- grid.64939.310000 0000 9999 1211Key Laboratory of Big Data-Based Precision Medicine, School of Engineering Medicine, Beihang University, Beijing, China
| | - Yao Sun
- Department of Implantology, Stomatological Hospital and Dental School of Tongji University, Shanghai Engineering Research Center of Tooth Restoration and Regeneration, Shanghai, China.
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6
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Blackwell MC, Thakkar B, Flores A, Zhang W. Extracolonic manifestations of Gardner syndrome: A case report. Imaging Sci Dent 2023. [DOI: 10.5624/isd.20230006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
Affiliation(s)
- McKenzie C. Blackwell
- Department of Surgical Sciences, East Carolina University School of Dental Medicine, Greenville, NC, USA
| | - Bhushan Thakkar
- Department of Surgical Sciences, East Carolina University School of Dental Medicine, Greenville, NC, USA
| | - Andres Flores
- Department of Surgical Sciences, East Carolina University School of Dental Medicine, Greenville, NC, USA
| | - Wenjian Zhang
- Department of General Dentistry, East Carolina University School of Dental Medicine, Greenville, NC, USA
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7
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Al-Zahrani MS, Alhassani AA, Zawawi KH. Clinical manifestations of gastrointestinal diseases in the oral cavity. Saudi Dent J 2021; 33:835-841. [PMID: 34938023 PMCID: PMC8665164 DOI: 10.1016/j.sdentj.2021.09.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Revised: 04/03/2021] [Accepted: 09/05/2021] [Indexed: 02/07/2023] Open
Abstract
Aim In this review, several gastrointestinal diseases that dentists may encounter in practice are highlighted and discussed. Materials and methods Using MEDLINE (PubMed), a comprehensive review of gastrointestinal diseases and their oral cavity manifestations was performed. Results Many gastrointestinal diseases present with oral symptoms that are detectable by dentists and dental hygienists. Often, oral manifestations of the disease may appear before systemic signs and symptoms. Managing patients with these conditions requires dentists to adjust their treatment and/or involve other health professionals. Conclusion Care must be taken when providing periodontal therapy or dental implants to patients suffering gastrointestinal diseases who are at high risk of bleeding, infection, or malnutrition, for example. Also, pharmacological therapy for these patients may need to be customized.
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Affiliation(s)
- Mohammad S Al-Zahrani
- Professor, Department of Periodontics, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Ahmed A Alhassani
- Assistant Professor, Department of Periodontics, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Khalid H Zawawi
- Professor, Department of Orthodontics, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabi
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8
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von Mehren M, Kane JM, Bui MM, Choy E, Connelly M, Dry S, Ganjoo KN, George S, Gonzalez RJ, Heslin MJ, Homsi J, Keedy V, Kelly CM, Kim E, Liebner D, McCarter M, McGarry SV, Meyer C, Pappo AS, Parkes AM, Paz IB, Petersen IA, Poppe M, Riedel RF, Rubin B, Schuetze S, Shabason J, Sicklick JK, Spraker MB, Zimel M, Bergman MA, George GV. NCCN Guidelines Insights: Soft Tissue Sarcoma, Version 1.2021. J Natl Compr Canc Netw 2020; 18:1604-1612. [PMID: 33285515 DOI: 10.6004/jnccn.2020.0058] [Citation(s) in RCA: 158] [Impact Index Per Article: 39.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
The NCCN Guidelines for Soft Tissue Sarcoma provide recommendations for the diagnosis, evaluation, treatment, and follow-up for patients with soft tissue sarcomas. These NCCN Guidelines Insights summarize the panel discussion behind recent important updates to the guidelines, including the development of a separate and distinct guideline for gastrointestinal stromal tumors (GISTs); reconception of the management of desmoid tumors; inclusion of further recommendations for the diagnosis and management of extremity/body wall, head/neck sarcomas, and retroperitoneal sarcomas; modification and addition of systemic therapy regimens for sarcoma subtypes; and revision of the principles of radiation therapy for soft tissue sarcomas.
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Affiliation(s)
| | | | | | - Edwin Choy
- 4Massachusetts General Hospital Cancer Center
| | - Mary Connelly
- 5The Ohio State University Comprehensive Cancer Center - James Cancer Hospital and Solove Research Institute
| | - Sarah Dry
- 6UCLA Jonsson Comprehensive Cancer Center
| | | | | | | | | | - Jade Homsi
- 10UT Southwestern Simmons Comprehensive Cancer Center
| | | | | | - Edward Kim
- 13Fred Hutchinson Cancer Research Center/Seattle Cancer Care Alliance
| | - David Liebner
- 5The Ohio State University Comprehensive Cancer Center - James Cancer Hospital and Solove Research Institute
| | | | | | - Christian Meyer
- 16The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins
| | - Alberto S Pappo
- 17St. Jude Children's Research Hospital/The University of Tennessee Health Science Center
| | | | | | | | - Matthew Poppe
- 21Huntsman Cancer Institute at the University of Utah
| | | | - Brian Rubin
- 23Case Comprehensive Cancer Center/University Hospitals Seidman Cancer Center and Cleveland Clinic Taussig Cancer Institute
| | | | - Jacob Shabason
- 25Abramson Cancer Center at the University of Pennsylvania
| | | | - Matthew B Spraker
- 27Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine
| | - Melissa Zimel
- 28UCSF Helen Diller Family Comprehensive Cancer Center; and
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9
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Importance of Extraintestinal Manifestations in Early Diagnosis of Gardner Syndrome. Case Rep Gastrointest Med 2020; 2020:7394928. [PMID: 32832171 PMCID: PMC7426784 DOI: 10.1155/2020/7394928] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Revised: 07/23/2020] [Accepted: 07/23/2020] [Indexed: 11/17/2022] Open
Abstract
Gardner's syndrome is an autosomal dominant disease caused by a mutation in the APC gene with 20–30% of cases presenting de novo. This entity is a variant of familial adenomatous polyposis, with a prevalence of 3/100,000 habitants. It may present as early as 2 months of age with a variety of both colonic and extracolonic symptoms. We report a case of a 21-year-old man, without any known family history, presenting with microcytic hypochromic anemia and constitutional symptoms for two months. Ultimately, after the etiological study, Gardner syndrome diagnosis was established as an index primary familiar case. Gardner syndrome is a clinical challenge which requires a prompt suspicion in order to reach its diagnosis. Given the malignant evolution of adenomas in 100% of untreated patients, early identification of extraintestinal manifestations (identifiable prior to colonic symptoms) is of the essence. A consequent endoscopic study to confirm gastrointestinal involvement is essential for a more favorable prognosis.
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10
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Chen PW, Wang LS, Wang YH, Fang XD. [Gardner syndrome with chronic osteomyelitis of the jaw: a case report]. HUA XI KOU QIANG YI XUE ZA ZHI = HUAXI KOUQIANG YIXUE ZAZHI = WEST CHINA JOURNAL OF STOMATOLOGY 2018; 36:457-460. [PMID: 30182577 DOI: 10.7518/hxkq.2018.04.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Gardner syndrome is a rare autosomal dominant disease. Its symptoms include multiple intestinal polyps, soft tissue tumors, dental disorders, osteoma, and congenital hypertrophy of the retinal pigment epithelium. Here, we present a patient with Gardner syndrome and chronic osteomyelitis of the jaw to highlight the serious damage that can be caused by Gardner syndrome.
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Affiliation(s)
- Pei-Wen Chen
- Dept. of Oral Implantology, Xiangya Stomatological Hospital, Central South University, Changsha 410008, China
| | - Le-Shi Wang
- Dept. of Periodontics, Xiangya Stomatological Hospital, Central South University, Changsha 410008, China
| | - Yue-Hong Wang
- Dept. of Oral Implantology, Xiangya Stomatological Hospital, Central South University, Changsha 410008, China
| | - Xiao-Dan Fang
- Dept. of Oral and Maxillofacial Surgery, Xiangya Stomatological Hospital, Central South University, Changsha 410008, China
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11
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Yu F, Cai W, Jiang B, Xu L, Liu S, Zhao S. A novel mutation of adenomatous polyposis coli (APC) gene results in the formation of supernumerary teeth. J Cell Mol Med 2017; 22:152-162. [PMID: 28782241 PMCID: PMC5742724 DOI: 10.1111/jcmm.13303] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2017] [Accepted: 05/27/2017] [Indexed: 12/15/2022] Open
Abstract
Supernumerary teeth are teeth that are present in addition to normal teeth. Although several hypotheses and some molecular signalling pathways explain the formation of supernumerary teeth, but their exact disease pathogenesis is unknown. To study the molecular mechanisms of supernumerary tooth‐related syndrome (Gardner syndrome), a deeper understanding of the aetiology of supernumerary teeth and the associated syndrome is needed, with the goal of inhibiting disease inheritance via prenatal diagnosis. We recruited a Chinese family with Gardner syndrome. Haematoxylin and eosin staining of supernumerary teeth and colonic polyp lesion biopsies revealed that these patients exhibited significant pathological characteristics. APC gene mutations were detected by PCR and direct sequencing. We revealed the pathological pathway involved in human supernumerary tooth development and the mouse tooth germ development expression profile by RNA sequencing (RNA‐seq). Sequencing analysis revealed that an APC gene mutation in exon 15, namely 4292‐4293‐Del GA, caused Gardner syndrome in this family. This mutation not only initiated the various manifestations typical of Gardner syndrome but also resulted in odontoma and supernumerary teeth in this case. Furthermore, RNA‐seq analysis of human supernumerary teeth suggests that the APC gene is the key gene involved in the development of supernumerary teeth in humans. The mouse tooth germ development expression profile shows that the APC gene plays an important role in tooth germ development. We identified a new mutation in the APC gene that results in supernumerary teeth in association with Gardner syndrome. This information may shed light on the molecular pathogenesis of supernumerary teeth. Gene‐based diagnosis and gene therapy for supernumerary teeth may become available in the future, and our study provides a high‐resolution reference for treating other syndromes associated with supernumerary teeth.
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Affiliation(s)
- Fang Yu
- Department of Pediatric Dentistry, School & Hospital of Stomatology, Tongji University, Shanghai Engineering Research Center of Tooth Restoration and Regeneration, Shanghai, China
| | - Wenping Cai
- Center for Translational Neurodegeneration and Regenerative Therapy, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China.,Department of Stomatology, Huashan Hospital, Fudan University, Shanghai, China
| | - Beizhan Jiang
- Department of Endodontics, School & Hospital of Stomatology, Shanghai Engineering Research Center of Tooth Restoration and Regeneration, Tongji University, Shanghai, China
| | - Laijun Xu
- Department of Stomatology, Huashan Hospital, Fudan University, Shanghai, China
| | - Shangfeng Liu
- Department of Stomatology, Huashan Hospital, Fudan University, Shanghai, China
| | - Shouliang Zhao
- Department of Stomatology, Huashan Hospital, Fudan University, Shanghai, China.,Department of Endodontics, School & Hospital of Stomatology, Shanghai Engineering Research Center of Tooth Restoration and Regeneration, Tongji University, Shanghai, China
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12
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Lu X, Yu F, Liu J, Cai W, Zhao Y, Zhao S, Liu S. The epidemiology of supernumerary teeth and the associated molecular mechanism. Organogenesis 2017; 13:71-82. [PMID: 28598258 DOI: 10.1080/15476278.2017.1332554] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
Supernumerary teeth are common clinical dental anomalies. Although various studies have provided abundant information regarding genes and signaling pathways involved in tooth morphogenesis, which include Wnt, FGF, BMP, and Shh, the molecular mechanism of tooth formation, especially for supernumerary teeth, is still unclear. In the population, some cases of supernumerary teeth are sporadic, while others are syndrome-related with familial hereditary. The prompt and accurate diagnosis of syndrome related supernumerary teeth is quite important for some distinctive disorders. Mice are the most commonly used model system for investigating supernumerary teeth. The upregulation of Wnt and Shh signaling in the dental epithelium results in the formation of multiple supernumerary teeth in mice. Understanding the molecular mechanism of supernumerary teeth is also a component of understanding tooth formation in general and provides clinical guidance for early diagnosis and treatment in the future.
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Affiliation(s)
- Xi Lu
- a Department of Stomatology , Huashan Hospital, Fudan University , Shanghai , P.R. China
| | - Fang Yu
- b Department of Pediatric Dentistry , School & Hospital of Stomatology, Tongji University, Shanghai Engineering Research Center of Tooth Restoration and Regeneration , Shanghai , P. R. China
| | - Junjun Liu
- a Department of Stomatology , Huashan Hospital, Fudan University , Shanghai , P.R. China
| | - Wenping Cai
- a Department of Stomatology , Huashan Hospital, Fudan University , Shanghai , P.R. China
| | - Yumei Zhao
- b Department of Pediatric Dentistry , School & Hospital of Stomatology, Tongji University, Shanghai Engineering Research Center of Tooth Restoration and Regeneration , Shanghai , P. R. China
| | - Shouliang Zhao
- a Department of Stomatology , Huashan Hospital, Fudan University , Shanghai , P.R. China
| | - Shangfeng Liu
- a Department of Stomatology , Huashan Hospital, Fudan University , Shanghai , P.R. China
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13
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Verma P, Surya V, Kadam S, Umarji HR. Classical presentation of Gardner's syndrome in an Indian patient: A case report. Contemp Clin Dent 2016; 7:277-80. [PMID: 27307686 PMCID: PMC4906882 DOI: 10.4103/0976-237x.183063] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Gardner's syndrome is an autosomal dominant disease characterized by the presence of colonic polyposis, osteomas, and a multitude of soft-tissue tumors. Dental anomalies are present in estimated 30% of all affected individuals of Gardner's syndrome, so dental professionals play an important role in determining the early signs of the syndrome. The intestinal polyps have a 100% risk of undergoing malignant transformation if not treated thus, early diagnosis and regular surveillance are important. In this report, we describe classical presentation of Gardner's syndrome in a patient who presented with bilateral swellings on palate along with multiple impacted teeth.
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Affiliation(s)
- Priyanka Verma
- Department of Oral Medicine and Radiology, Government Dental College and Hospital, Nagpur, Maharashtra, India
| | - Varun Surya
- Department of Oral Pathology, Maulana Azad Institute of Dental Sciences, New Delhi, India
| | - Sonali Kadam
- Department of Oral Medicine and Radiology, Government Dental College and Hospital, Mumbai, Maharashtra, India
| | - Hemant R Umarji
- Department of Oral Medicine and Radiology, Government Dental College and Hospital, Mumbai, Maharashtra, India
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Gardner's syndrome presenting with a fibromatous tumour of the parotid. Eur Ann Otorhinolaryngol Head Neck Dis 2016; 133:357-359. [PMID: 27291484 DOI: 10.1016/j.anorl.2016.05.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
INTRODUCTION Gardner's syndrome is the association of familial adenomatous polyposis (FAP) with an anaphase promoting complex (APC) gene mutation and several extradigestive manifestations: osteomas, epidermal cysts and desmoid tumours. Only 2 cases of FAP associated with parotid tumour have been reported in the literature: one carcinoma and one pleomorphic adenoma. CASE REPORT We report the case of a 23-year-old man with Gardner's syndrome presenting with a fibromatous tumour of the left parotid gland. The other clinical manifestations were an osteoma of the skull base and a mesentery desmoid tumour. Left total parotidectomy was performed, followed by gastroscopy and colonoscopy, demonstrating numerous colonic adenomas. Genetic analysis revealed an APC gene mutation, confirming the diagnosis. Total prophylactic colectomy was performed. CONCLUSIONS This is the first reported case of Gardner's syndrome associated with a fibromatous tumour of the parotid. Early management of FAP is essential to prevent colorectal cancer that occurs in 100% of untreated cases. The rarity of this syndrome and the parotid site can lead to delayed diagnosis.
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15
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A Rare Case Report on Suboccipital Region Benign Giant Osteoma. Case Rep Neurol Med 2016; 2016:2096701. [PMID: 27051540 PMCID: PMC4804070 DOI: 10.1155/2016/2096701] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2015] [Accepted: 02/21/2016] [Indexed: 11/18/2022] Open
Abstract
Herein we report a rare case of a giant suboccipital osteoma in a 55-year-old woman presenting primarily due to cosmetic issue. We discuss the management algorithm taken in the patient, highlighting excision of a potentially curable bony tumor only after ruling out its extension to the ear cavity, mastoid ear cells, transverse sinus, and the intracranial compartment.
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Qin B, Jiang W, Jing Z, Zhao L. Non-syndrome multiple impacted teeth and supernumerary teeth in a family: A report of 2 cases. JOURNAL OF ORAL AND MAXILLOFACIAL SURGERY, MEDICINE, AND PATHOLOGY 2016. [DOI: 10.1016/j.ajoms.2015.07.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Total gastroduodenectomy with pancreatic preservation for the treatment of Gardner's syndrome with gastroduodenal polyposis and malignant transformation. Cir Esp 2015; 94:196-8. [PMID: 26049684 DOI: 10.1016/j.ciresp.2015.04.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2015] [Revised: 04/20/2015] [Accepted: 04/22/2015] [Indexed: 11/23/2022]
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Abstract
BACKGROUND Benign bone tumors and tumor-like lesions are much more frequent than malignant bone tumors among the total number of tumors of the skeleton. OBJECTIVE This article gives a presentation of the characteristics and treatment modalities of benign bone tumors. MATERIAL AND METHODS In this article in-house treatment principles are compared with those in the currently available literature. RESULTS Benign bone tumors are frequently found incidentally; however, the term benign does not always signify that a purely observational role is needed. Benign bone tumors differ in their biological behavior and can be latent, active or aggressive which determines the treatment approach. Some benign bone tumors are just as aggressive locally as malignant tumors. The most important diagnostic feature is still conventional radiography and a thorough systematic analysis is necessary. Therapy options range from ignore, wait and see up to wide resection. In contrast to malignant tumors the radicalism of resection can be weighed against the accompanying local control and loss of function. CONCLUSION The treatment of benign bone tumors depends on the histological type and the biological activity. Most benign bone tumors are diagnosed incidentally and do not necessitate any treatment.
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Affiliation(s)
- A Hillmann
- Orthopädische Klinik, Klinikum Ingolstadt, 85049, Ingolstadt, Deutschland,
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Mucoepidermoid carcinoma: A yet unreported cancer associated with familial adenomatous polyposis. J Craniomaxillofac Surg 2014; 42:262-4. [DOI: 10.1016/j.jcms.2013.05.012] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2013] [Revised: 05/07/2013] [Accepted: 05/10/2013] [Indexed: 11/18/2022] Open
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Carini F, Giamberini C, Cappelletti D, Francesconi M, Porcaro G. Prevalenza e gestione chirurgica degli elementi sovrannumerari. Uno studio retrospettivo. DENTAL CADMOS 2013. [DOI: 10.1016/s0011-8524(13)70109-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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