Inversion 16 Leukemia Possible Associated With Familial Sinus Bradycardia And Bridging Of Ribs

摘要

Tumor predisposition syndromes might account for a larger percentage of childhood cancers than currently estimated. A 61 years old man admitted for frequent epistaxis attacks in the last 15 days. The patient’s heart rate was 40 beats/min. Sinus bradycardia rhythm was seen in the electrocardiography (ECG) examination and non-specific T waves were present on D3, AVF derivations of ECG. Chest radiography showed only bridging between anterior portion of second and third ribs. The diagnosis of acute myeloblastic leukemia (AML) with recurrent genetic abnormalities- inv 16- ( according to WHO classification) was confirmed by bone marrow biopsy, flow cytometry and genetic evaluation. Constitutional genetic defects should be important for leukemogenic potential. Introduction Tumor predisposition syndromes might account for a larger percentage of childhood cancers than currently estimated. Several studies have shown a relationship between childhood cancer and the presence of major and minor anomalies in children (1). Here, we report sinus bradycardia and bridging of ribs possible associated with inversion 16 leukemia, to our knowledge, that has not been reported before. Case Report A 61 years old man admitted for frequent epistaxis attacks in the last 15 days. Physical examination showed petechias at low extremities and asymptomatic bradycardia. The patient’s heart rate was 40 beats/min. Chest radiography showed only bridging between anterior portion of second and third ribs (figure, arrow). Sinus bradycardia rhythm was seen in the electrocardiography (ECG) examination and non-specific T waves were present on D3, AVF derivations of ECG (figure legend).