Lumbosacral spina bifida in a case with Pallister-Killian syndrome

Abstract

Pallister-Killian syndrome (PKS) is a rare disorder caused by tissue limited mosaic tetrasomy of 12p. PKS is clinically characterized with facial dysmorphism, mental-motor retardation, hypotonia and internal abnormalities. Most widely seen features include diaphragmatic hernia, rhizomelic upper limbs and cardiac abnormalities. It is diagnosed by means of cytogenetic analysis of amniocytes, chorionic villus, fetal blood lymphocytes or fibroblasts. Cytogenetic analysis of lymph ocytes usually shows up normal result. Here, we report a fetus demonstrating irregular vertebral body alignment, omphalocele and left ventricle hypoplasia detected in fetal ultrasonography eva luation of a woman referred to our hospital at 19-week gestational age because of high risk for neural tube defect in second trimester screening test. Cytogenetic analysis was not performed in chorionic villus or amniocytes. The pregnancy was terminated at 20-week gestational age. PKS was suspected because of the omphalocele and sacral appendage findings in postmortem examin ation. Skin fibroblast culture revealed 47, XY, i (12) (p10) karyotype, confirming the diagnosis. This is the first case of PKS with lumbosacral spina bifida reported. Sacral appendage is a rare finding and reported in few cases. Cytogenetic investigation is the most widely used method to diagnose PKS and is helpful to differentiate PKS from Fryns syndrome that may bear similar clinical findings.