Increased prevalence of minor anomalies in childhood malignancy

Abstract

Body measurements were taken and the prevalence of major malformations and of 57 minor anomalies was determined in 106 children with malignant disease, in 81 of their sibs, and in 106 control subjects matched to the patients according to sex, age and ethnic origin. Leukaemic children had a significantly smaller head circumference than the corresponding control children, but no significant differences in height, weight, anthropometric and syndromologic indices were found. No differences were observed in the frequency of associated major malformations including renal malformations detectable by sonography. The prevalence of minor anomalies was significantly higher in the patients with malignant disease and their sibs than in the control children: 69.2% of the patients, 63.0% of the sibs and 34.6% of the control subjects had at least one minor anomaly. When two and more minor anomalies were considered, the prevalence figures were 36.5%, 29.6% and 12.5%, respectively. Among the single minor anomalies only the Sydney line was significantly more frequent in patients with solid tumours. No specific association of an individual dysplasia or a pattern of minor anomalies with a given tumour could be established.

Excess of congenital abnormalities in French-Canadian children with neuroblastoma: A case series study from Montreal

“…However, these findings were not supported in a study from the Manchester Children's Tumour Registry [23]. In a comparable study of numerous types of childhood cancer, there was an excess of minor (but not major) anomalies in 106 affected children compared with the same number of age, sex, and ethnicity-matched controls [26]. Of note was the excess of minor anomalies in the sibs of cases: 69.2% of cases, 63.0% of sibs, and 34.6% of control children had one or more minor anomaly.…”

Minor phenotypic variants in patients with acute lymphoblastic leukaemia from west Mexico

“…21 A Sydney crease is a variation in the palmar flexion creases originally described in children with leukaemia by Menser and Purvis-Smith, and is an age-dependent feature, 39 defined as an extension of the five-finger crease to the ulnar border of the palm. Our results, together with those of Méhes et al 18 and Durmaz et al, 21 allow us to identify it as a morphological characteristic associated with children with leukaemia. The reported association with CALS, 19,20,27,28 also observed by us, has been confirmed in the absence of neurofibromatosis or other entities associated with CALS.…”

“…Despite these limitations, the previous studies 18---21,27 and our own agree in finding that children with leukaemia have an excess of MPVs, which indicates that one or more prenatal factors cause both MPVs and cancer, although they have not enabled us to identify the associated types of MPVs conclusively. The MPVs that seem to emerge by showing an association or statistically significant differences in children with leukaemia in at least 2 or more studies include variations in palmar flexion creases, 18,21 pigmented naevi 19,20 and café-au-lait spots (CALS), 19,20,27 whilst hypertelorism, epicanthus, synophrys, high arched palate, low-set ears, absent ear lobule, syndactyly, clinodactyly and hallux valgus are MPVs reported in a single study. 21 A Sydney crease is a variation in the palmar flexion creases originally described in children with leukaemia by Menser and Purvis-Smith, and is an age-dependent feature, 39 defined as an extension of the five-finger crease to the ulnar border of the palm.…”

“…We also find that few studies include an anthropometric assessment for defining the presence of the various MPVs. Méhes et al 18 report a significantly higher frequency of microcephaly in children with leukaemia; however, this finding was not confirmed in our study, and neither was the tall stature reported by Merks et al 22 Although they were not observed in the previous studies, 16,18 we highlight the presence of narrow ears and wide-spaced nipples observed in the physical examination and confirmed anthopometrically in our study (Tables 3 and 4), since they may constitute reproducible elements for consideration as further candidate signs associated with ALL.…”

“…16---24 Unlike major anomalies, the study of MPVs requires a thorough external physical examination and anthropometric measurements for each patient, but they have the disadvantage that many MPVs are assessed subjectively, and varying terminology and classifications are used to refer to them. 25,26 Association studies between MPVs and various types of solid tumours in children 18,23 and haemotologic neoplasms 16,19---21,27,28 agree that these children have an excessive number of MPVs, but no consensus has yet been reached as to the specific types or patterns of associated MPVs. Acute leukemias are the main type of neoplasm in children and in Mexico it is estimated that between 1000 and 2000 new cases of this cancer are diagnosed every year, 29 the highest percentage of which corresponds to ALL.…”