痣样基底细胞癌综合征1例报告

痣样基底细胞癌综合征是一种罕见的常染色体显性遗传疾病，以颌骨多发性角化囊肿、皮肤痣样基底细胞癌及多种骨骼异常为主要临床表现。作者报告1例典型病例．并对其临床、病理和治疗进行了讨论．     

痣样基底细胞癌综合征家系1例

痣样基底细胞癌综合征是一种罕见的常染色体显性遗传病,以发育异常和肿瘤发生为主要临床特征。本文报告1例痣样基底细胞癌综合征家系,并结合相关文献对该病的发病率、发病机制、临床表现、治疗方法等进行讨论。     

多发性基底细胞痣综合征6例报告

<正> 多发性基底细胞痣或基底细胞癌综合征的主要表现包括多发性痣样基底细胞癌或基底细胞痣、颌骨囊肿,颅骨畸形和异位钙化(如大脑镰钙化)等。本综合征属常染色体显性遗传,有明显的家属性。     

基底细胞痣综合征的诊治

目的 研究基底细胞痣综合征的发病情况、临床表现、诊断和治疗方法.方法 回顾性总结1999-2007年期间在天津医科大学总医院治疗的4例基底细胞痣综合征的诊断和治疗过程.结果 该综合征患者具有典型的面部特征,皮肤可见基底细胞痣(癌),手掌或足底可见特殊凹陷,骨骼系统常有单侧或双侧肋骨分叉和异常钙化,大部分患者有多发性颌骨角化囊肿的口腔表现.本组病例未发现家族史.结论 多发性颌骨角化囊肿是基底细胞痣综合征的重要临床表现之一,及时正确的治疗能使患者获得良好的生存质量.     

痣样基底细胞癌综合征的分子机制

痣样基底细胞癌综合征具有常染色体显性遗传特征,由肿瘤抑制基因PTCH突变所致。PTCH的一个等位基因发生单独的点突变可能是该综合征中各种畸形的原因所在。PTCH的两个等位基因同时 失活会导致肿瘤和囊肿(基底细胞癌、牙源性角化囊肿和成神经管细胞瘤)的形成。一些新假说的提出可能有助于解释该综合征较为少见的原因。     

痣样基底细胞癌综合征的分子机制

痣样基底细胞癌综合征具有常染色体显性遗传特征，由肿瘤抑制基因ＰＴＣＨ突变所致。ＰＴＣＨ的一个等位基因发生单独的点突变可能是该综合征中各种畸形的原因所在。ＰＴＣＨ的两个等位基因同时失活会导致肿瘤和囊肿（基底细胞癌、牙源性角化囊肿和成神经管细胞瘤）的形成。一些新假说的提出可能有助于解释该综合征较为少见的原因。     

痣样基底细胞癌综合征1例报告

痣样基底细胞癌综合征（Naevoid basal cell carcinoma syn-drome,NBCCS）又称Gorlin-Goltz综合征。由White于1894首次描述,是由皮肤基底细胞癌、多发性颌骨角化囊肿及骨骼系统异常和各种其他病变组成的综合征,常伴有多器官发育障碍。我科最近收治1例,报告如下。     

基底细胞痣综合征的牙源性角化囊肿中Ki-67表达的研究

目的：探讨基底细胞痣综合征的牙源性角化囊肿细胞增殖活性与临床生物学行为的关系。方法：利用Ki-67单克隆抗体，免疫组化方法（LSAB法）检测基底细胞痣综合征的牙源性角化囊肿和非综合征的牙源性角化囊肿中Ki-67表达情况。结果：Ki-67在基底细胞痣综合征的牙源性角化囊肿衬里上皮中的表达主要位于基底上层，且明显高地单发和复发牙源性角化囊肿，结论：基底细胞痣综合征的牙源性角化囊肿较非综合征的角化囊肿具有更高的细胞增殖殖活性，与其较高的复发潜能有关。     

13例痣样基底细胞癌综合征的临床、X线及组织病理表现

这种同时出现有多发性痣样基底细胞上皮瘤、多发性颌骨囊肿、双叉肋及其他骨骼常异的疾患,为Gorlin等于1960年首先报告。目前均认为此病为一种特殊的综合征。同义词尚有“基底细胞痣综合征”、“多发性基底细胞痣综合征”、“痣样基底细胞癌综合征”等。此综合征有多种不同表现,主要有:①     

基底细胞痣综合征的遗传和诊治

基底细胞痣综合征的遗传和诊治河北省医院口腔科温华丽，杜兆军，李宪起基底细胞痣综合征的主要特点是多发性牙源性角化囊肿，并有皮肤基底细胞痣及骨骼系统畸形及其它异常。文献报告有增多的趋向。但系统地家族遗传史罕见。本文因１例颌骨大型角化囊肿，曾７次手术又复发...     

Nevoid basal cell carcinoma syndrome associated with renal cysts and hypertension

A case of nevoid basal cell carcinoma syndrome with a coincidental finding is presented. In addition to the odontogenic cysts, hypertelorism, scapula deformity, rib fusion, dural calcification, and short fourth metacarpal bones of the syndrome, the patient had cystic disease of both kidneys with a large cyst of the right kidney. This case also illustrates that the presence of painful jaw lesions may lead the patient with this syndrome to seek treatment initially.     

A mandibular swelling

Nevoid basal cell carcinoma syndrome (NBCCS) is characterised by skeletal anomalies, cutaneous basal cell carcinomas and multiple keratocysts. NBCCS is an autosomal dominant disorder, but can have a variable phenotypic penetration. NBCCS can also arise spontaneously. The prevalence is 1:60.000 and 50-65% of patients with NBCCS have affected family members. A recently diagnosed patient is presented and the manifestations of the syndrome are discussed.     

A case of central odontogenic fibroma of the mandible in a nevoid basal cell carcinoma syndrome patient

Nevoid basal cell carcinoma syndrome (NBCCS) is an autosomal dominant disorder characterized by tumorigenesis and physical deformities. Although more than 50 clinical manifestations have been described, only two major criteria or one major and two minor criteria are necessary for diagnosis. The most frequently observed manifestation in the oral and the maxillofacial region is an odontogenic keratocyst. In this study, we describe a 14-year-old boy with a diagnosis of NBCCS who presented with a central odontogenic fibroma (COF) in the mandible. This report highlights the importance of precise diagnosis and the choice of surgical method for COF.     

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.     

痣样基底细胞癌综合征伴先天性左眼缺失1例

痣样基底细胞癌综合征（NBCCS）又称基底细胞痣综合征或Goltz-Gorlin综合征，是一种复杂且罕见的常染色体显性遗传疾病，大量研究文献证实PTCH1基因与NBCCS有关。本文报道1例NBCCS伴先天性左眼缺失的病例，并结合相关文献探讨以进一步了解该综合征。     

Gorlin's syndrome. Case report

The authors present a case of Gorlin's Syndrome, more satisfactorily defined as nevoid basal cell carcinoma syndrome (NBCS), a rare genetic disorder characterized mainly by multiple basal cell carcinomas and odontogenic keratocysts and other less frequent skeletal, sexual and neurological manifestations. Patient 75 years old, male. Previously treated surgically for multiple cutaneous basal cell carcinomas, comes to our Department to remove a suspected asymptomatic keratocyst. Clinical examination reveals cutaneous alterations of hands and feet (webbed hands and feet), a little progenism and multiple nevi and basal cell carcinomas on the body and the head. The oral cavity is free of alterations or clinical signs. NBCS is probably caused by chromosomal abnormalities of chromosome 5 and 9. The abnormalities seen in the latter are similar to those seen in people exposed for long periods to UV radiation. These abnormalities could determine malignant cutaneous tumors removing anti neoplastic protection. The association with odontogenic keratocysts, however not clearly understood, appears in more than 90% of cases. All the other disorders are less frequent. Juvenile basal cell carcinomas, especially if associated with odontogenic keratocysts suggest, the hypothesis of NBCS; if confirmed, this diagnosis makes further familial investigations necessary, to diagnose other cases, at the time unknown.     

Expression of cell cycle and apoptosis-related proteins in sporadic odontogenic keratocysts and odontogenic keratocysts associated with the nevoid basal cell carcinoma syndrome.

Odontogenic keratocysts are occasionally (4-5%) associated with the nevoid basal cell carcinoma syndrome, a pleiotropic, autosomal disorder presenting a spectrum of developmental abnormalities and a predisposition for the development of different neoplasms. The aim of this study was to establish whether keratocysts showing clinically aggressive behavior associated with nevoid basal cell carcinoma syndrome reflect differences in cellular proliferation rate and/or in the expression of oncoproteins and tumor suppressor genes. For this reason, formalin-fixed paraffin-embedded sections of odontogenic keratocysts associated with the nevoid basal cell carcinoma syndrome (16 cases) and sporadic odontogenic keratocysts (16 cases) were compared for expression of proliferating cell nuclear antigen (PCNA) and p53, bcl-2, and bcl-1 (cyclin D1) onco-proteins. Most of the epithelial lining of odontogenic keratocysts associated with the nevoid basal cell carcinoma syndrome showed nuclear immunopositivity for p53 protein and overexpression of cyclin D1 with various degrees of staining intensity. All sporadic odontogenic keratocysts were negative for p53 and cyclin D1. The expressions of bcl-2 oncoprotein were found to be substantially similar between the two groups of lesions, with a cytoplasmic immunopositivity localized only in the resting reserve basal layer of the epithelium. PCNA expression showed no statistically significant difference between the two groups of lesions. In conclusion, the finding of cyclin D1 and p53 overexpression in odontogenic keratocysts associated with the nevoid basal cell carcinoma syndrome could be considered a hallmark of a mutated cellular phenotype, thus leading to the hypothesis that their aggressive clinical behavior could be due to a dysregulation of the expression of cyclin D1 and p53 proteins, involved in a check-point control of cellular proliferation.     

Multiple recurrent and de novo odontogenic keratocysts associated with oral-facial-digital syndrome

In 1954, Papillon-Leage and Psaume were the first to describe the clinical characteristics of oral-facial-digital syndrome (OFDS). On the basis of their clinical features and the inheritance pattern, 2 variants were initially distinguished, namely OFDS type I (Papillon-Leage and Psaume) and OFDS type II, or Mohr syndrome. At present, 11 types of OFDS have been discovered. OFDS represents a heterogeneous group of disorders characterized by oral manifestations including oral frenula, cleft or lobulated tongue, high arched palate, cleft lip and/or palate, facial anomalies, and digital abnormalities such as syndactyly, polydactyly, brachydactyly, and clinodactyly. Depending on the type of OFDS, abnormalities may be present in other organs, such as the brain and heart. We report a patient with OFDS in whom multiple recurrent and de novo keratocysts were found. Although multiple keratocysts are commonly found in Gorlin-Goltz nevoid basal cell carcinoma syndrome, a relationship between OFDS and multiple keratocysts has not been described.     

Nevoid basal cell carcinoma syndrome: a retrospective analysis of 33 affected Korean individuals

This article describes a pooled analysis of Korean individuals with nevoid basal cell carcinoma syndrome (NBCCS). The data upon which this review is based has been retrieved from published case reports in Korean dental and medical literature between the years 1981 to 2002. We found 33 subjects who met the diagnostic criteria for NBCCS. Relative frequencies of associated complications are presented and compared with those of the English literature. Odontogenic keratocyst (OKC) and palmar and/or plantar pits, and hypertelorism were the most frequently observed anomalies. OKCs are often the first signs of NBCCS and can be detected in patients younger than 20 years of age. However, the incidence and clinical manifestations of NBCCS in Korean individuals were found to be rather different from those of other countries. The relatively low frequency of basal cell carcinomas and falx calcification among the major criteria were two major differences. The frequencies of the minor criteria concur in general with the ranges given by some others. It is concluded that these differences may be attributed to genetic and geographic differences.