Background. Nevoid basal cell carcinoma syndrome,or NBCCS, is a hereditary
condition characterized by basal cell carcinomas, or BCCs; odontogenic kera
tocysts, or OKCs; and skeletal abnormalities. The authors conducted this st
udy to determine the early signs of NBCCS.
Methods. The authors reviewed files from two Italian dental schools from Ja
nuary 1980 to January 1995 to determine the early signs of NBCCS and the ag
e at which patients were first examined. They re-examined all of the patien
ts, using the diagnostic criteria for NBCCS.
Results. The authors found 14 patients who fulfilled the criteria for diagn
osis of NBCCS in five families. All of the patients were 16 years bf age or
younger. In 11 cases (78 percent), the first sign of NBCCS in the patients
was an OKC. The OKCs diagnosed in patients older than 13 years of age were
large and characterized by widespread bone resorption. One Ii-year-old pat
ient had six large OKCs. The authors also found a case of multiple OKCs in
an 8-year-old patient. Only one patient showed BCCs.
Conclusions. OKCs are often the first signs of NBCCS and can be detected in
patients younger than 10 years of age. Our data suggest that OKCs arise ea
rlier in patients who have NBCCS than in patients who do not have NBCCS. Th
e patients' young ages explain the low incidence of BCCs in this study.
Clinical Implications. The presence of multiple OKCs in a child or onset of
BCC in a patient younger than 20 years of age should alert dentists to the
possibility of the patient's having NBCCS.