La sindrome di Gorlin o del Carcinoma Nevo Basocellulare (NBCCS) è una malattia autosomica dominante a penetranza completa ed espressività variabile, dovuta a mutazioni del gene PTCH1 che mappa in 9q22.3.
La sindrome è caratterizzata da una serie di anomalie dello sviluppo e dalla predisposizione a sviluppare tumori di vario tipo.
Le manifestazioni più frequenti sono :
carcinomi basocellulari,
cheratocisti odontogenetiche,
Pits palmo-plantari (sono fossette poco profonde presenti nell'87% dei casi),
calcificazioni falce cerebrale (presenti nel 90% dei casi),
anomalie cranio-facciali (macrocrania con bozze frontali prominenti, fronte alta e larga, naso a sella, ipertelorismo).
La diagnosi prenatale è difficilissima, i segni ecografici da ricercare sono:
ventricolomegalia,
anomalie facciali (bozze frontali, ipertelorismo, naso a sella),
macrocefalia,
tumori multipli.
Essendo trasmessa con carattere autosomico dominante a penetranza completa, il 70/80% dei casi eredita il gene mutato da un genitore; il 20/30% è dovuto a mutazioni de novo. Il test molecolare può quindi essere proposto laddove sia nota la mutazione causale presente in consanguinei; l'assenza di mutazioni nei genitori orienta verso un verosimile caso sporadico dovuto quindi a mutazioni de novo.
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