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Proteus syndrome revealing itself after the treatment of a bilateral subdural haematoma.
[proteus syndrome]
Hypertrophy
of
the
calvarium
has
different
aetiologies
,
among
them
the
rare
Proteus
syndrome
.
We
report
here
the
case
of
a
young
girl
initially
treated
for
relapsing
right
then
left
large
chronic
subdural
haematoma
,
who
progressively
developed
craniofacial
hypertrophy
consistent
with
the
diagnosis
of
Proteus
syndrome
.
Calvarium
hypertrophy
was
shaved
and
remodelled
combining
midface
advancement
,
essentially
for
cosmetic
purposes
.
During
the
first
calvarium
remodelling
,
important
bleeding
of
the
bone
required
large
volume
of
blood
replacement
.
Haemostasis
workup
revealed
platelets
aggregation
anomalies
.
Bleeding
issues
during
subsequent
surgeries
were
controlled
with
tranexamic
acid
and
desmopressin
acetate
.
Other
manifestations
of
Proteus
syndrome
,
such
as
a
right
hypertrophy
of
the
face
with
hypoplasia
of
its
middle
third
,
a
pigmented
epidermal
nevus
and
asymmetric
limbs
and
scoliosis
,
appeared
progressively
over
time
.
Blood
and
fibroblast
phosphatase
and
tensin
homolog
mutation
was
not
found
.
Literature
review
of
operated
patients
with
Proteus
syndrome
did
not
reveal
an
association
with
platelets
anomalies
.
A
complete
haemostasis
workup
following
this
unexpected
haemorrhagic
complication
is
recommended
for
this
rare
pathology
.
Diseases
Validation
Diseases presenting
"a pigmented epidermal nevus and asymmetric limbs and scoliosis"
symptom
proteus syndrome
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