title: Multifocal desmoplastic medulloblastoma in an african-american child with nevoid basal cell carcinoma (gorlin) syndrome. Case report.
abstract: The authors present the case of a 2.5-year-old African-American boy with desmoplastic medulloblastoma (MB) and nevoid basal cell carcinoma syndrome (NBCCS), also known as Gorlin syndrome, an autosomal dominant disorder resulting from mutations in the patched (PTCH) gene that predisposes to neoplasias (including basal cell carcinomas [BCCs] and MB) and to widespread congenital malformations. The diagnosis of NBCCS was suspected based on the clinical examination, patient and family medical histories, and histopathological characteristics of the tumor. Radiotherapy was withheld. The diagnosis of NBCCS was confirmed by DNA testing, which revealed a novel mutation in the PTCH gene. This is the first report of an African-American child with MB diagnosed with NBCCS prior to radiotherapy. Although only a small number of patients with MB have NBCCS, the diagnosis must be considered because radiotherapy in such patients can lead to the formation of BCCs and other intracranial neoplasms within the irradiated field. This case emphasizes the importance of obtaining thorough family and patient medical histories and of carefully examining the patient and close relatives for signs of NBCCS to avoid the potentially devastating consequences of missing this diagnosis.
authors.affiliation: Division of Pediatric Neurosurgery, James Whitcomb Riley Hospital for Children, Indiana University School of Medicine, Indianapolis, Indiana 46202, USA.
authors.forename: Philip S
authors.initials: PS
authors.lastname: Smucker
authors.forename: Jodi L
authors.initials: JL
authors.lastname: Smith
mesh_terms: D001741:Black or African American; D001478:Basal Cell Nevus Syndrome / Q000175:diagnosis* / Q000208:ethnology / Q000235:genetics / Q000601:surgery; D001932:Brain Neoplasms / Q000175:diagnosis* / Q000208:ethnology / Q000235:genetics / Q000601:surgery; D002528:Cerebellar Neoplasms / Q000175:diagnosis* / Q000208:ethnology / Q000601:surgery; D002551:Cerebral Ventricle Neoplasms / Q000175:diagnosis* / Q000208:ethnology / Q000601:surgery; D002675:Child, Preschool; D003388:Cranial Fossa, Posterior; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008527:Medulloblastoma / Q000175:diagnosis* / Q000208:ethnology / Q000601:surgery; D009154:Mutation; D009378:Neoplasms, Multiple Primary / Q000175:diagnosis* / Q000208:ethnology / Q000601:surgery; D000072079:Patched Receptors; D000072081:Patched-1 Receptor; D011956:Receptors, Cell Surface / Q000235:genetics
chemical_list: C000606236:PTCH1 protein, human; D000072079:Patched Receptors; D000072081:Patched-1 Receptor; D011956:Receptors, Cell Surface