Patients can present to different specialists, depending on the first sign of the syndrome. It is very common for families to remain undiagnosed for several generations despite have been seen by doctors from a variety of disciplines.
Diagnosis in a child at 50% risk of having inherited the condition may not be easy because of the extreme variation in expression, both within and between families. Some children many have on rib anomalies whilst other have the 'typical face' without other signs. Gene tracking and mutation analysis may be helpful for presymptomatic diagnosis.
For apparently isolated cased, detailed examination and x-ray investigation of the parents should be undertaken before concluding that a child's condition is the result of a new mutation. If an adult has no physical signs, no pertinent history and normal radiology, it is unlikely that he or she has Gorlin Syndrome. Direct mutation analysis of the gene may be helpful.
Confident diagnosis is obviously, vital for subsequent surveillance for complications such as BCCs and jaw cysts, and for giving genetic information. Clinically it relies on a detailed family history, and physical and x-ray examinations.
Diagnostic criteria based on the most frequent and/or specific features of the syndrome are given in Journal of Medical Genetics, Volume 30, 1993, pages 460-464. and itemised below:
Originally produced by Professor P. A. Farndon, Clinical Geneticist, Jim Costello (deceased) and Margaret Costello. We are reliant on a team of medical advisors for the clinical content of the website. We are grateful for their continuing support.
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