Currarino syndrome: proposal of a diagnostic and therapeutic protocol.
OBJECTIVE
The Currarino syndrome (CS) is a peculiar form of caudal regression syndrome (CRS) characterized by the association of hemisacrum, anorectal malformation (ARM), and presacral mass. The authors analyzed retrospectively their series, and they propose a multidisciplinary diagnostic and therapuetic protocol that until now has not been introduced.


METHODS
A series of 6 patients with CS is presented. Five of them were treated initially in other centers. None of them had an early diagnosis. All presented associated anomalies; in 50%, Hirschsprung's disease (HD) and other dysganglionoses were present. One patient died of a presacral ectopic nephroblastoma.


RESULTS
Depending on the expressivity, 3 types of CS can be identified, complete, mild, and minimal. Dysganglionoses and HD can be considered part of CS. A multidisciplinary diagnostic and therapeutic protocol is presented. Main points are sacrum x-Ray, molecular genetic diagnosis, radiologic evaluation of every member of CS families, magnetic resonance (MR) evaluation of patient spine and pelvis, suction rectal biopsies, and search for associated anomalies.


CONCLUSIONS
This protocol could give a valid contribution to the treatment of CS, allowing an early diagnosis and proposing a rational timing of multidisciplinary surgical procedures. Early diagnosis and treatment are essential to avoid morbidity and mortality from an undiagnosed presacral mass.
Martucciello
G
G
Division of Pediatric Surgery, Gaslini Children's Hospital, Genoa, Italy.
Torre
M
M
Belloni
E
E
Lerone
M
M
Pini Prato
A
A
Cama
A
A
Jasonni
V
V
D000015:Abnormalities, Multiple / Q000175:diagnosis* / Q000235:genetics / Q000601:surgery*; D001003:Anal Canal / Q000002:abnormalities*; D002897:Chromosomes, Human, Pair 7 / Q000235:genetics; D003050:Coccyx / Q000002:abnormalities; D003125:Colostomy; D003248:Constipation / Q000209:etiology; D042241:Early Diagnosis; D017809:Fatal Outcome; D005260:Female; D005799:Genes, Dominant; D006627:Hirschsprung Disease / Q000150:complications; D018398:Homeodomain Proteins / Q000235:genetics; D006801:Humans; D007231:Infant, Newborn; D008067:Lipoma / Q000235:genetics; D008159:Lumbar Vertebrae / Q000002:abnormalities; D008297:Male; D008588:Meningocele / Q000150:complications / Q000175:diagnosis* / Q000601:surgery*; D009436:Neural Tube Defects / Q000209:etiology; D010386:Pelvic Neoplasms / Q000235:genetics; D010641:Phenotype; D012003:Rectal Fistula / Q000151:congenital; D012007:Rectum / Q000002:abnormalities*; D012189:Retrospective Studies; D012447:Sacrum / Q000002:abnormalities*; D013577:Syndrome; D013724:Teratoma / Q000235:genetics; D014157:Transcription Factors / Q000235:genetics; D014621:Vagina / Q000002:abnormalities; D009396:Wilms Tumor / Q000150:complications / Q000235:genetics
D018398:Homeodomain Proteins; C490003:MNX1 protein, human; D014157:Transcription Factors