Orthopedics · Bone Tumors (Benign and Malignant)

A 40-year-old woman with known polyostotic fibrous dysplasia presents with café-au-lait spots with irregular ('Coast of Maine') borders and precocious puberty in her daughter. The syndrome combining polyostotic fibrous dysplasia, endocrine hyperfunction, and café-au-lait macules is called:

  • A McCune-Albright syndrome
  • B Ollier's disease
  • C Maffucci syndrome
  • D Neurofibromatosis type 1 (NF-1)
Correct answer: A. McCune-Albright syndrome

Explanation

McCune-Albright syndrome is the triad of polyostotic fibrous dysplasia + café-au-lait skin macules with irregular 'Coast of Maine' borders (vs the smooth 'Coast of California' borders of NF-1) + autonomous endocrine hyperfunction (precocious puberty being commonest; also hyperthyroidism, acromegaly, Cushing's). It is caused by a somatic activating mutation in GNAS (Gsα subunit). Ollier's disease is multiple enchondromatosis without skin/endocrine features. Maffucci syndrome adds hemangiomas to enchondromas with high malignant transformation risk. NF-1 café-au-lait spots have smooth borders and is associated with neurofibromas, not precocious puberty.

Reference: Maheshwari Essential Orthopaedics, 6th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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