Prenatal ultrasound diagnosis of megalencephaly-polymicrogyria-polydactyly-hydrocephalus syndrome with persistent hyperplastic primary vitreous: a case report

Introduction: Megalencephaly-polymicrogyria-polydactyly-hydrocephalus (MPPH) syndrome is a rare autosomal dominant disorder characterised by megalencephaly (i.e. overgrowth of the brain), polymicrogyria and focal hypoplasia of the cerebral cortex and polydactyly. Persistent hyperplastic primary vitreous (PHPV) involves a spectrum of congenital ocular abnormalities that are characterised by the presence of a vascular membrane behind the lens. Case Presentation: Here, we present a case of foetal MPPH with PHPV that was diagnosed using prenatal ultrasound. Ultrasound revealed the presence of megacephaly, multiple cerebellar gyri and hydrocephalus. Whole-exome sequencing confirmed the mutation of the AKT3 gene, which led to the consideration of MPPH syndrome. Moreover, an echogenic band with an irregular surface was observed between the lens and the posterior wall of the left eye; therefore, MPPH with PHPV was suspected. Conclusion: MPPH syndrome with PHPV can be diagnosed prenatally.