Two cases with an extra small metacentric chromosome are described. Cl
assic cytogenetic analysis was insufficient for identification of the
marker origin. High resolution banding and fluorescence in situ hybrid
ization (FISH) using a chromosome specific painting probe indicated th
at both marker chromosomes originated from chromosome 18. The correlat
ion between phenotype, cytogenetics and FISH results allowed us to con
clude that the patients are tetrasomic for 18p. A comparison of the cl
inical features of our two patients with other twelve previously repor
ted patients where tetrasomy 18p was confirmed, is also presented.