{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T19:52:35Z","timestamp":1792785155072,"version":"4.5.0"},"reference-count":31,"publisher":"Georg Thieme Verlag KG","issue":"04","license":[{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Intramural Research Program of the National Institute of Dental and Craniofacial Research, National Institutes of Health","id":[{"id":"https:\/\/ror.org\/004a2wv92","id-type":"ROR","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Neurol Surg Rep"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Background McCune\u2013Albright syndrome is a rare mosaic disorder caused by postzygotic activating mutations in GNAS, classically presenting with fibrous dysplasia (FD), hyperpigmented macules, and endocrinopathies. Craniofacial FD is common and typically follows a benign course. However, acute symptomatic changes with aggressive imaging features may mimic malignant transformation or secondary lesions such as aneurysmal bone cysts (ABCs), creating significant diagnostic uncertainty.<\/jats:p>\n                  <jats:p>Case Description We report a 20-year-old woman with known MAS and polyostotic FD who presented with a 4-week history of progressive left frontal swelling, headache, and tenderness. Interval imaging revealed a rapidly enlarging erosive lytic lesion of the left frontal calvarium with peripheral enhancement and an internal fluid\u2013fluid level, raising concern for secondary pathology or malignancy. Given rapid growth and cortical erosion, the patient underwent surgical resection with cranioplasty. Intraoperatively, the lesion contained serosanguinous fluid. Histopathology demonstrated bland spindle cell proliferation with curvilinear woven bone trabeculae and hemosiderin-laden macrophages, without cytologic atypia, necrosis, or features of ABC. Molecular testing confirmed a GNAS p.(R201C) mutation, consistent with FD. The patient had an uncomplicated postoperative course with complete symptom resolution.<\/jats:p>\n                  <jats:p>Conclusion This case highlights that fluid\u2013fluid levels, rapid interval growth, and erosive changes can occur in craniofacial FD without ABC formation or malignant transformation. Imaging findings alone are insufficient to distinguish benign changes from aggressive pathology. Accurate diagnosis requires a multimodal approach integrating clinical context, advanced imaging, histopathology, and pathologic analysis. Surgical intervention is justified in some cases to establish diagnosis and provide symptomatic relief.<\/jats:p>","DOI":"10.1055\/a-2947-3017","type":"journal-article","created":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T23:38:35Z","timestamp":1790897915000},"page":"e214-e218","source":"Crossref","is-referenced-by-count":0,"title":["Acute Enlargement of a Frontal Calvarial Lesion in Polyostotic Fibrous Dysplasia Associated with McCune\u2013Albright Syndrome: A Case Report"],"prefix":"10.1055","volume":"87","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-4437-5336","authenticated-orcid":false,"given":"David","family":"Zhang","sequence":"additional","affiliation":[{"name":"Northwestern University Feinberg School of Medicine, Illinois, United States","place":["Chicago"],"department":["Department of Neurological Surgery"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel A.","family":"Multz","sequence":"additional","affiliation":[{"name":"Northwestern University Feinberg School of Medicine, Illinois, United States","place":["Chicago"],"department":["Department of Pathology"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pouya","family":"Jamshidi","sequence":"additional","affiliation":[{"name":"Northwestern University Feinberg School of Medicine, Illinois, United States","place":["Chicago"],"department":["Department of Pathology"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alison M.","family":"Boyce","sequence":"additional","affiliation":[{"name":"Metabolic Bone Disorders Unit, National Institute of Dental and Craniofacial Research, National Institutes of Health, Maryland, United States","place":["Bethesda"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Allison J.","family":"Hahr","sequence":"additional","affiliation":[{"name":"Northwestern University Feinberg School of Medicine, Illinois, United States","place":["Chicago"],"department":["Division of Endocrinology, Metabolism and Molecular Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen T.","family":"Magill","sequence":"additional","affiliation":[{"name":"Northwestern University Feinberg School of Medicine, Illinois, United States","place":["Chicago"],"department":["Department of Neurological Surgery"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2026,10,15]]},"reference":[{"issue":"02","key":"ref1","doi-asserted-by":"crossref","first-page":"345","DOI":"10.1210\/endrev\/bnz011","article-title":"Fibrous dysplasia\/McCune-Albright syndrome: a rare, mosaic disease of G\u03b1s activation","volume":"41","author":"A M Boyce","year":"2020","journal-title":"Endocr Rev"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1016\/j.bjps.2025.08.013","article-title":"Skeletal and endocrine manifestations of McCune-Albright syndrome in patients with fibrous dysplasia","volume":"109","author":"A M 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