Presacral teratoma in a Curarrino syndrome woman with an unreported insertion in MNX1 gene

Taiwan J Obstet Gynecol. 2011 Dec;50(4):512-4. doi: 10.1016/j.tjog.2011.10.020.

Abstract

Objective: Currarino syndrome (CS) comprises a presacral mass, anorectal malformation, and a sacral bony defect. It is rarely reported in the gynecological field.

Case report: We describe here the case of a 26-year-old married woman with Currarino syndrome who presented with a presacral teratoma and a previously unreported insertion in MNX1 gene. She had had a pelvic teratoma diagnosed by laparoscopy 8 years previously. She was referred to our clinic because of the increasing size of the teratoma and associated compression symptoms. Computed tomography demonstrated a heterogeneous 12 cm mass in the presacral region. Spina bifida at S2eS5 was also noted. Laparotomy confirmed the diagnosis of presacral teratoma. Genetic analysis disclosed a triple CGC repeat insertion in exon 1 of MNX1, resulting in three in-frame shifts encoding for the amino acid alanine. No siblings had known similar symptoms.

Conclusion: Currarino syndrome is known to be an autosomal dominant disorder. The presence of constipation can lead to a diagnosis of the syndrome early in childhood. In sporadic cases diagnosis is late because of atypical symptoms. Delayed treatment of a presacral tumor may cause serious complications such as central nervous system infection or subsequent neurological dysfunction. In clinical practice, a presacral tumor with a sacral bony defect may indicate Currarino syndrome. Genetic analysis of the family may provide information on the hereditary traits of specific MNX1 mutation.

Publication types

  • Case Reports

MeSH terms

  • Abnormalities, Multiple / diagnosis*
  • Abnormalities, Multiple / genetics
  • Adult
  • Anal Canal / abnormalities
  • Digestive System Abnormalities / diagnosis*
  • Digestive System Abnormalities / genetics
  • Female
  • Homeodomain Proteins / genetics*
  • Humans
  • Mutagenesis, Insertional*
  • Pelvic Neoplasms / diagnosis*
  • Pelvic Neoplasms / genetics
  • Rectum / abnormalities
  • Sacrococcygeal Region
  • Sacrum / abnormalities
  • Spinal Dysraphism / diagnosis*
  • Spinal Dysraphism / genetics
  • Syringomyelia / diagnosis*
  • Syringomyelia / genetics
  • Teratoma / diagnosis*
  • Teratoma / genetics
  • Transcription Factors / genetics*

Substances

  • Homeodomain Proteins
  • MNX1 protein, human
  • Transcription Factors

Supplementary concepts

  • Currarino triad