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Background  Poland Syndrome (PS) is a rare disorder characterized by hypoplasia/aplasia of the pectoralis major muscle, variably associated with thoracic and upper limb anomalies. Familial recurrence has been reported indicating that PS could have a genetic basis, though the genetic mechanisms underlying PS development are still unknown.    Case presentation  Here we describe a couple of monozygotic (MZ) twin girls, both presenting with Poland Syndrome. They carry a  de novo  heterozygous 126 Kbp deletion at chromosome 11q12.3 involving 5 genes, four of which, namely  HRASLS5 ,  RARRES3 ,  HRASLS2 , and  PLA2G16 , encode proteins that regulate cellular growth, differentiation, and apoptosis, mainly through Ras-mediated signaling pathways.    Conclusions  Phenotype concordance between the monozygotic twin probands provides evidence supporting the genetic control of PS. As genes controlling cell growth and differentiation may be related to morphological defects originating during development, we postulate that the observed chromosome deletion could be causative of the phenotype observed in the twin girls and the deleted genes could play a role in PS development.

De novo deletion of chromosome 11q12.3 in monozygotic twins affected by Poland Syndrome