Sirenomelia: A Multi-systemic Polytopic Field Defect with Ongoing Controversies
Publication year
2017Source
Birth Defects Research, 109, 10, (2017), pp. 791-804ISSN
Publication type
Article / Letter to editor

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Organization
Anatomy
Medical Imaging
Journal title
Birth Defects Research
Volume
vol. 109
Issue
iss. 10
Page start
p. 791
Page end
p. 804
Subject
Radboudumc 0: Other Research DCMN: Donders Center for Medical Neuroscience; Radboudumc 0: Other Research RIHS: Radboud Institute for Health SciencesAbstract
The most impressive phenotypic appearance of sirenomelia is the presence of a 180 degrees -rotated, axially positioned, single lower limb. Associated gastrointestinal and genitourinary anomalies are almost always present. This rare anomaly is still the subject of ongoing controversies concerning its nosology, pathogenesis, and possible genetic etiology. Sirenomelia can be part of a syndromic continuum, overlapping with other complex conditions including caudal dysgenesis and VATER/VACTERL/VACTERL-H associations, which could all be part of a heterogeneous spectrum, and originate from an early defect in blastogenesis. It is imaginable that different "primary field defects," whether or not genetically based, induce a spectrum of caudal malformations. In the current study, we review the contemporary hypotheses and conceptual approaches regarding the etiology and pathogenesis of sirenomelia, especially in the context of concomitant conditions. To expand on the latter, we included the external and internal dysmorphology of one third trimester sirenomelic fetus from our anatomical museum collection, in which multiple concomitant but discordant anomalies were observed compared with classic sirenomelia, and was diagnosed as VACTERL-H association with sirenomelia. Birth Defects Research, 2017.(c) 2017 The Authors. Birth Defects Research Published by Wiley Periodicals, Inc.
This item appears in the following Collection(s)
- Academic publications [227613]
- Electronic publications [107273]
- Faculty of Medical Sciences [86193]
- Open Access publications [76399]
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