ORAL AND MAXILLOFACIAL PATHOLOGY Editor: Alan R. Gould Thurston syndrome: Report of a new case Ashima Valiathan, BDS, DDS, MS, a Arunachalam Sivakumar, BDS, MDS, b David Marianayagam, BDS, c Manna Valiathan, MBBS, MD, d and Kapaettu Satyamoorthy, MSc, PhD, e Manipal, India MANIPAL COLLEGE OF DENTAL SCIENCES Thurston syndrom (oro-facial-digital syndrome type V) is an autosomal recessive condition characterized by median cleft of the upper lip, postaxial polydactyly of hands and feet, and oral manifestations. According to earlier reports, the syndrome is predominantly seen in subjects of Indian descent. We report a cast of Thurston syndrome in a 13-year-old south Indian boy who presented with oral features, incomplete median cleft of upper lip, and polydactyly of both hands and left foot. A precise clinical differentiation must be made since considerable overlap of the features of the various other forms could give rise to difficulties in diagnosing the condition. (Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2006;101:757-60) The term oral-facial-digital syndrome (OFDS) designates a group of heterogeneous clinical patterns, of which 9 different subtypes have been described. 1,2 The syndrome is characterized by oral, facial, and digital malforma- tions with a considerable overlap of the features, giving rise to difficulties in precise clinical differentiation. Thurston syndrome is OFD type V, first described by Thurston in 1909. 3 It is an autosomal recessive condi- tion characterized by median cleft of upper lip, frenulum duplication, and postaxial polydactyly of hands and feet. Oral manifestations of Thurston syndrome include enamel hypoplasia, hypodontia, hyperplastic frenae, supernumerary teeth, and highly arched palate. A case of Thurston syndrome in a 13-year-old south Indian boy with incomplete median cleft of upper lip and polydactyly of both hands and left foot is presented. This is the fifth instance of the anomaly in a patient of Indian descent out of 7 cases reported in the literature. Fig. 1. The notch in the midline of the upper lip vermilion. a Professor and Head, Department of Orthodontics, Manipal College of Dental Sciences, Manipal, India. b Assistant Professor, Department of Orthodontics, Manipal College of Dental Sciences, Manipal, India. c Postgraduate Student, Department of Orthodontics, Manipal College of Dental Sciences, Manipal, India. d Associate Professor, Department of General Pathology, Kasturba Medical College, Manipal, India. e Professor and Senior Scientist, Center for Molecular and Cellular Biology, Department of Biotechnology, Kasturba Medical College, Manipal, India. Received for publication Jun 16, 2005; returned for revision Aug 11, 2005; accepted for publication Aug 16, 2005. 1079-2104/$ - see front matter Ó 2006 Mosby, Inc. All rights reserved. doi:10.1016/j.tripleo.2005.08.011 757 Vol. 101 No. 6 June 2006