title: CLOVES syndrome: review of a PIK3CA-related overgrowth spectrum (PROS).
abstract: Overgrowth syndromes are characterized by global or localized disproportionate growth associated with other anomalies, including vascular malformations and neurological and/or visceral disorders. CLOVES (Congenital Lipomatous asymmetric Overgrowth of the trunk with lymphatic, capillary, venous, and combined-type Vascular malformations, Epidermal naevi, Scoliosis/Skeletal and spinal anomalies) is an overgrowth syndrome caused by mosaic activating mutation in gene PIK3CA, which gives rise to abnormal PI3K-AKT-mTOR pathway activation. These mutations are responsible for the clinical manifestations of the syndrome, which include low- and high-flow vascular malformations, thoracic lipomatous hyperplasia, asymmetric growth, and visceral and neurological disorders. These common anomalies are illustrated with figures from two personal cases. Identification of the clinical and genetic characteristics of CLOVES syndrome is crucial for the differential diagnosis with other overgrowth syndromes, such as Proteus or Klippel-Trenaunay (K-T) syndromes, and for the therapeutic management of the different anomalies. In this context, a new entity comprising different syndromes with phenotypic mutations in PIK3CA has been proposed, designated PIK3CA-related overgrowth spectrum (PROS), with the aim of facilitating clinical management and establishing appropriate genetic study criteria.
authors.affiliation: Dermatology Unit, Complejo Hospitalario Universitario, Granada, Spain.
authors.forename: A
authors.identifier: 0000-0003-0304-7317
authors.initials: A
authors.lastname: Martinez-Lopez
authors.affiliation: Dermatology Unit, Complejo Hospitalario Universitario, Granada, Spain.
authors.forename: G
authors.initials: G
authors.lastname: Blasco-Morente
authors.affiliation: Dermatology Unit, Complejo Hospitalario Universitario, Granada, Spain.
authors.forename: I
authors.initials: I
authors.lastname: Perez-Lopez
authors.affiliation: Neurological Unit, Complejo Hospitalario Universitario, Granada, Spain.
authors.forename: J D
authors.initials: JD
authors.lastname: Herrera-Garcia
authors.affiliation: Orthopedical Unit, Complejo Hospitalario Universitario, Granada, Spain.
authors.forename: M
authors.initials: M
authors.lastname: Luque-Valenzuela
authors.affiliation: Internal Medicine Unit, Complejo Hospitalario Universitario, Granada, Spain.
authors.forename: D
authors.initials: D
authors.lastname: Sanchez-Cano
authors.affiliation: Vascular Malformations Unit, Hospital Infantil La Paz, Madrid, Spain.
authors.forename: J C
authors.initials: JC
authors.lastname: Lopez-Gutierrez
authors.affiliation: Dermatology Unit, Complejo Hospitalario Universitario, Granada, Spain.
authors.forename: R
authors.initials: R
authors.lastname: Ruiz-Villaverde
authors.affiliation: Dermatology Unit, Complejo Hospitalario Universitario, Granada, Spain.
authors.forename: J
authors.initials: J
authors.lastname: Tercedor-Sanchez
mesh_terms: D000015:Abnormalities, Multiple / Q000235:genetics* / Q000473:pathology; D058534:Class I Phosphatidylinositol 3-Kinases; D006130:Growth Disorders / Q000473:pathology; D006801:Humans; D008067:Lipoma / Q000473:pathology*; D009139:Musculoskeletal Abnormalities / Q000473:pathology*; D009154:Mutation; D009506:Nevus / Q000473:pathology*; D019869:Phosphatidylinositol 3-Kinases / Q000235:genetics*; D013577:Syndrome; D054079:Vascular Malformations / Q000473:pathology*
chemical_list: D019869:Phosphatidylinositol 3-Kinases; D058534:Class I Phosphatidylinositol 3-Kinases; C484760:PIK3CA protein, human
keywords: CLOVES syndrome; PIK3CA; PIK3CA-related overgrowth spectrum; overgrowth syndromes