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October 1968

Noonan's Syndrome: A Case With Elevated Serum Alkaline Phosphatase Levels and Malignant Schwannoma of the Left Forearm

Author Affiliations

Madison, Wis
From the departments of surgery (Dr. Kaplan), pediatrics (Dr. Opitz), and pathology (Dr. Gosset), University of Wisconsin Medical School, Madison, Wis.

Am J Dis Child. 1968;116(4):359-366. doi:10.1001/archpedi.1968.02100020363003

THIS report concerns a particularly interesting patient with a complex dysmorphogenetic syndrome and an elevated level of serum alkaline phosphatase who developed a malignant schwannoma.

Report of a Case  The patient (No. 501867, born Dec 22, 1951) was first admitted to the University of Wisconsin Hospitals at the age of 5 years for dyspnea on exertion and cyanosis.The patient was delivered by caesarean section due to placenta previa after a full-term pregnancy. His birth weight was 3,345 gm (7 lb 6 ounces); his birth length is unknown. During the first year of life, he failed to gain weight satisfactorily; a cardiac murmur was first heard around the age of 12 months. He became cyanotic primarily during breath-holding spells. His penis had been noted to be large since birth.At the time of his first admission to the University Hospitals, he appeared to be a small, pale child, measuring 104

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