Array comparative genomic hybridisation in a fetus with thoracic ectopia cordis: a case report

Background. Ectopia cordis (EC) is a rare anomaly characterized by abnormal heart positioning. The exact etiology remains unknown, is likely to be associated with genetic and environmental factors. The introduction of an array-based comparative genomic hybridization (a-CGH) test has broadened our understanding of the genetic basis of many fetal anomalies, providing a more precise characterization of imbalances and allowing the comparison of the phenotype with other patients displaying imbalances in the same region. We report a rare case of ectopia cordis associated with the coexistence of a rare deletion in chromosome 19.
Case presentation. A 28-year-old primigravida was referred to our hospital for abortion. Ultrasonography was performed to establish a gestational age of 17th weeks. A single fetus with isolated ectopia cordis with herniation of the heart from the right chest has been reported. The patient underwent therapeutic abortion. Anatomopathological examination of the fetus and whole genome a-CGH of the DNA of a flap of fetal skin was performed. Based on the cytogenetic analysis, the fetal karyotype was 46, XX. A-CGH analysis has detected a deletion of the short arm of chromosome 19 in the 19p13.3 band, containing the OMIM genes: TLE6-2-5, GNA11 and GNA15, S1PR4, and NCLN.
Conclusions. The diagnosis of EC with sonography is important to identify the main defect and its associated abnormalities. There is no evidence that EC is a genetically transmitted disease, however, a-CGH analysis may be an excellent tool in providing adequate counselling for families.

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