A case of Rothmund-Thomson syndrome

Rothmund-Thomson 증후군 1례

  • Kim, Seung Hyo (Department of Pediatrics, College of Medicine, Seoul National University) ;
  • Shin, Choong Ho (Department of Pediatrics, College of Medicine, Seoul National University) ;
  • Yang, Sei Won (Department of Pediatrics, College of Medicine, Seoul National University)
  • 김승효 (서울대학교 의과대학 소아과학교실) ;
  • 신충호 (서울대학교 의과대학 소아과학교실) ;
  • 양세원 (서울대학교 의과대학 소아과학교실)
  • Received : 2005.10.31
  • Accepted : 2005.12.30
  • Published : 2006.05.15

Abstract

Rothmund-Thomson syndrome (RTS), is a rare autosomal recessive disorder, characterized by : skin photosensitivity, poikiloderma, sparse hair, sparse eyebrows/lashes, short stature, skeletal abnormalities, cataracts, and an increased risk of malignancy. Skeletal abnormalities include : dysplasia, absent or malformed bones, such as absent radii, osteopenia, and delayed bone formation. RTS is thought to result from chromosomal instability, and children with RTS are at risk of cancer. Reported cancers in children with RTS include : basal cell carcinoma, squamous cell carcinoma of the skin and osteosarcoma of bone. We report an 11 year-old boy, who presented to our institution with poikilodermatous skin change with telangiectasia and hyperpigmentation, absence of radius and thumb, and the development of osteosarcoma of the left tibia. The patient is now receiving supportive care and is receiving maintenance chemotherapy after surgery for osteosarcoma.

Rothmund-Thomson 증후군은 상염색체 열성질환으로 다형피부증(poikiloderma), 희박한 모발과 눈썹, 저신장, 골격계 이상, 유소년기 백내장과 악성종양의 위험이 높은 것으로 특징지어지는 증후군이다. 골격계의 이상은 RTS 환아의 68%에서 보고되었고 신체전반의 골격계 이형성으로 형성부전이나 기형으로 나타난다. 요골형성부전, 엄지손가락 저형성, 골감소증, 슬개골 저형성이나 슬개골 형성 부전 등이 보고되어 있다. 흔치 않은 증상으로는 말안장코와 삼각형의 얼굴 등이 보고되어있다. RTS에서 골육종을 포함한 악성종양의 발생빈도가 높고 면역학적 이상이 보고되어 있다. 피부종양이 가장 흔하며 상피세포암, 기저세포암, Bowen's disease 등이 있고 두 번째로는 육종이 흔하다. 저자들은 전신적으로 혈관확장 및 과색소침착을 보이는 다형 피부 소견과 함께 요골형성부전, 척골기형, 엄지손가락형성부전, 슬개골 형성부전의 골격계 기형이 있으면서 이후 좌측 경골에 골육종이 발생한 Rothmund-Thomson 증후군을 경험하였기에 보고하는 바이다.

Keywords

References

  1. Anbari KK, Ierardi-Curto LA, Silber JS, Asada N, Spinner N, Zackai EH, et al. Two primary osteosarcomas in a patient with Rothmund-Thomson syndrome. Clin Orthop 2000;378:213-23 https://doi.org/10.1097/00003086-200009000-00032
  2. Cumin I, Cohen JY, David A, Mechinaud F, Avet-Loiseau H, Harousseau JL. Rothmund-Thomson syndrome and osteosarcoma. Med Pediatr Oncol 1996;26:414-6 https://doi.org/10.1002/(SICI)1096-911X(199606)26:6<414::AID-MPO8>3.0.CO;2-K
  3. Pianigiani E, De Aloe G, Andreassi A, Rubegni P, Fimiani M. Rothmund-Thomson syndrome (Thomson-type) and myelodysplasia. Pediatr Dermatol 2001;18:422-5 https://doi.org/10.1046/j.1525-1470.2001.01971.x
  4. Pujol LA, Erickson RP, Heidenreich RA, and Cunniff C. Variable presentation of Rothmund-Thomson sydrome. Am J Med Genet 2000;95:204-7 https://doi.org/10.1002/1096-8628(20001127)95:3<204::AID-AJMG4>3.0.CO;2-Q
  5. Thomson MS. A hitherto undescribed familial disease. Br J Dermatol 1923;35:455-62 https://doi.org/10.1111/j.1365-2133.1923.tb09077.x
  6. Wang LL, Levy ML, Lewis RA, Chintagumpala MM, Lev D, Rogers M, et al. Clinical manifestations in a cohort of 41 Rothmund-Thomson syndrome patients. Am J Med Genet 2001;102:11-7 https://doi.org/10.1002/1096-8628(20010722)102:1<11::AID-AJMG1413>3.0.CO;2-A
  7. Haytac MC, Oztunc H, Mete UO, Kaya M. Rothmund- Thomson syndrome : A case report. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2002;94:479-84 https://doi.org/10.1067/moe.2002.127584
  8. Spurney C, Gorlick R, Meyers PA, Healey JH, Huvos AG. Multicentric osteosarcoma, Rothmund-Thomson syndrome, and secondary nasopharyngeal non-Hodgkin's lymphoma : a case report and review of the literature. J Pediatr Hematol Oncol 1998;20:494-7 https://doi.org/10.1097/00043426-199809000-00018
  9. Ying KL, Oizumi J, Curry CJR. Rothmund-Thomson syndrome associated with trisomy 8 mosaicism. Am J Med Genet 1990;27:258-60 https://doi.org/10.1136/jmg.27.4.258
  10. Lindor NM, Devries EM, Michels VV, Schad CR, Jalal SM, Donovan KM, et al. Rothmund-Thomson syndrome in siblings : evidence for acquired in vivo mosaicism. Clin Genet 1996;49:124-9 https://doi.org/10.1111/j.1399-0004.1996.tb03270.x
  11. Lindor NM, Furuichi Y, Kitao S, Shimamoto A, Arndt C, Jalal S. Rothmund-Thomson syndrome due to RECQ4 helicase mutations : report and clinical and molecular comparisons with Bloom syndrome and Werner syndrome. Am J Med Genet 2000;90:223-8 https://doi.org/10.1002/(SICI)1096-8628(20000131)90:3<223::AID-AJMG7>3.0.CO;2-Z
  12. Grant SG, Wenger SL, Latimer JJ, Thull D, Burke LW. Analysis of genomic instability using multiple assays in a patient with Rothmund-Thomson syndrome. Clin Genet 2000;58:209-15 https://doi.org/10.1034/j.1399-0004.2000.580308.x
  13. Lindor NM, Furuichi Y, Kitao S, Shimamoto A, Arndt C, Jalal S. Rothmund-Thomson syndrome due to RECQ4 helicase mutations : report and clinical and molecular comparisons with Bloom syndrome and Werner syndrome. Am J Med Genet 2000;90:223-38 https://doi.org/10.1002/(SICI)1096-8628(20000131)90:3<223::AID-AJMG7>3.0.CO;2-Z