There is a subgroup of patients carrying chromosomal rearrangements and large deletions of other gene (RPS19) who present macrocephaly instead of microcephaly as one of the reported craniofacial abnormalities [79]; however, we found no description of RPL11 LoF and overgrowth, as presented by the patient here discussed. The gene discussed is RPS19; the disease is microcephaly.