title: A Case of Beare-Stevenson Syndrome with Unusual Manifestations.
abstract: BACKGROUND
  Beare-Stevenson syndrome (BSS) is an extremely rare genetic disorder, with fewer than 25 cases reported worldwide. This autosomal dominant syndrome has been linked to two mutations in the fibroblast growth factor receptor 2 gene (FGFR2), Tyr375Cys and Ser372Cys, both causing amino acid changes.
  
  
  METHODS
  BSS is characterized by a range of morphological features, some more classically associated than others, of which craniosynostosis has been almost uniformly present. Other common features include cutis gyrata, acanthosis nigricans, ear and eye defects, skin/mucosal tissue tags, prominent umbilical stump, and anogenital anomalies. This account reports what we believe to be the 25th case of BSS, and exhibits a constellation of the characteristic features similar to those previously described, including the presence of cutis gyrata, proptosis, a bifid scrotum, and hypospadias. However, craniosynostosis was not detected prenatally by ultrasound or at birth. Prenatal ultrasound may detect some dysmorphic features of BSS. Many of these features have also been associated with other genetic disorders with overlapping phenotypes. Our case presented with the unusual features of a natal tooth and absence of craniosynostosis at birth. At birth, a diagnosis of BSS was suspected based on clinical features despite the absence of craniosynostosis. This was later confirmed with the use of molecular analysis, revealing a Tyr375Cys mutation of exon 9 of the FGFR2 gene.
  
  
  CONCLUSIONS
  We suggest that a normal antenatal ultrasound scan and the absence of craniosynostosis at birth should not preclude further workup for BSS if this possibility is clinically suspected.
authors.affiliation: , New York Methodist Hospital, Brooklyn, NY, USA.
authors.forename: Nitin
authors.initials: N
authors.lastname: Ron
authors.affiliation: , New York Methodist Hospital, Brooklyn, NY, USA.
authors.forename: Samuel
authors.initials: S
authors.lastname: Leung
authors.affiliation: , Mount Sinai School of Medicine, New York, NY, USA.
authors.forename: Erin
authors.initials: E
authors.lastname: Carney
authors.affiliation: , Bachelor of Science, The College of William and Mary, Williamsburg, VA, USA.
authors.forename: Alexis
authors.initials: A
authors.lastname: Gerber
authors.affiliation: , Albert Einstein College of Medicine, New York, NY, USA.
authors.forename: Karen Laurie
authors.initials: KL
authors.lastname: David
mesh_terms: D000052:Acanthosis Nigricans / Q000175:diagnosis* / Q000235:genetics; D003398:Craniosynostoses / Q000175:diagnosis* / Q000235:genetics; D004423:Ear / Q000002:abnormalities*; D005091:Exons; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D020125:Mutation, Missense; D009306:Natal Teeth; D035583:Rare Diseases; D051497:Receptor, Fibroblast Growth Factor, Type 2 / Q000235:genetics; D012536:Scalp Dermatoses / Q000175:diagnosis* / Q000235:genetics; D012868:Skin Abnormalities / Q000175:diagnosis* / Q000235:genetics; D014430:Twins, Monozygotic
chemical_list: D051497:Receptor, Fibroblast Growth Factor, Type 2