PMC7433959_01
Disproportionate body proportions of the patient
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F1
Based on clinical examination and CT scan, the patient was diagnosed with Sotos syndrome and remained under follow-up there till the age of 2 years [Figure 1].
Appearance of the patient when he presented to our department (showing frontal bossing, broad chin)
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F2
When the patient was examined in our department [Figure 2], he was found to be well oriented to time, place, and person.
Increased fronto-occipital circumference
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F3
On general physical examination, he had frontal bossing, increased fronto-occipital circumference (56 cm) [Figure 3], sparse hair at frontoparietal region, broad-square chin, kyphoscoliosis and mild pectus excavatus along with hypopigmented areas around his mid chest and umbilical regions [Figures 4-6].
Scoliosis
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F4
On general physical examination, he had frontal bossing, increased fronto-occipital circumference (56 cm) [Figure 3], sparse hair at frontoparietal region, broad-square chin, kyphoscoliosis and mild pectus excavatus along with hypopigmented areas around his mid chest and umbilical regions [Figures 4-6].
Kyphosis
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F5
On general physical examination, he had frontal bossing, increased fronto-occipital circumference (56 cm) [Figure 3], sparse hair at frontoparietal region, broad-square chin, kyphoscoliosis and mild pectus excavatus along with hypopigmented areas around his mid chest and umbilical regions [Figures 4-6].
Anterior view of chest and abdomen showing de-pigmented patch near umbilicus
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F6
On general physical examination, he had frontal bossing, increased fronto-occipital circumference (56 cm) [Figure 3], sparse hair at frontoparietal region, broad-square chin, kyphoscoliosis and mild pectus excavatus along with hypopigmented areas around his mid chest and umbilical regions [Figures 4-6]. The patient also had umbilical hernia [Figure 6], multiple palmar-plantar pits [Figure 7], muscle hypotonia, and right side testicular atrophy.
Palmar plantar pits
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F7
The patient also had umbilical hernia [Figure 6], multiple palmar-plantar pits [Figure 7], muscle hypotonia, and right side testicular atrophy.
Intra-oral examination
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F8
Oral cavity [Figure 8] appeared to have several missing, decayed, and tilted teeth with overall poor oral hygiene and high-arched palate.
Preoperative orthopantomogram
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F9
Upper canine and molars were still descending down toward occlusion and a supernumerary tooth (paramolar) was present in maxilla on the left side [Figure 9].
Anteroposterior view of the skull showing falx cerebri calcificatio
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F10
The lateral skull view and posterior-anterior view skull revealed falx cerebri calcification [Figure 10].
Chest X-ray showing 4th bifid rib on the right side
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F11
The chest X-ray of the patient revealed bifid and fused 4th rib on the right side [Figure 11].
Marsupialization of cyst
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F12
Under general anesthesia, the cyst was marsupialized extending from the mesial surface of 36 to the mesial surface of 46 and iodoform gauge pack given [Figure 12].
Histopathologic slide showing cyst lining
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F13
While enucleation of cyst was done with respect to the 17 region, the cystic contents and lining were sent for the histopathologic examination, which revealed lining epithelium, stroma with inflammatory infiltrate containing plasma cells and eosinophils [Figures 13-16].
Histopathologic slide showing odontogenic keratocyst
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F14
While enucleation of cyst was done with respect to the 17 region, the cystic contents and lining were sent for the histopathologic examination, which revealed lining epithelium, stroma with inflammatory infiltrate containing plasma cells and eosinophils [Figures 13-16].
Histopathologic slide showing stroma with plasma cells
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F15
While enucleation of cyst was done with respect to the 17 region, the cystic contents and lining were sent for the histopathologic examination, which revealed lining epithelium, stroma with inflammatory infiltrate containing plasma cells and eosinophils [Figures 13-16].