{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,13]],"date-time":"2026-02-13T13:34:38Z","timestamp":1770989678139,"version":"3.50.1"},"reference-count":30,"publisher":"Scientific Scholar","content-domain":{"domain":["surgicalneurologyint.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:sec id=\"st1\">\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>\n                      Craniofacial fibrous dysplasia (CFD) is a rare benign fibro-osseous disorder characterized by the replacement of normal bone with fibrous tissue, frequently resulting in craniofacial deformity, functional impairment, and neurological complications. Its pathogenesis is strongly associated with somatic\n                      <jats:italic>GNAS<\/jats:italic>\n                      gene mutations, which disrupt osteoprogenitor cell differentiation.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"st2\">\n                    <jats:title>Case Description:<\/jats:title>\n                    <jats:p>This study presents a 35-year retrospective review (1985\u20132019) of patients diagnosed with CFD at the National Cancer Institute of Mexico. Six adult patients (mean age 42.6 years, 66.7% females) met inclusion criteria. Polyostotic disease predominated (83.3%), with the sphenoid and ethmoid bones most frequently involved. Facial dysmorphism was the initial manifestation in 83.3% of cases, whereas headache was less common. Visual acuity was preserved in most patients, although cranial nerve involvement was identified in two cases. Using Chen\u2019s classification, multilocal disease affecting all three craniofacial zones was the most prevalent pattern (50%), correlating with greater surgical complexity. The mean Karnofsky Performance Status was 95, reflecting good functional status despite the disease burden. Two representative complex cases illustrate the challenges of surgical decision-making, highlighting the role of staged resections, craniofacial reconstruction, and the integration of advanced technologies such as virtual surgical planning and biomaterials.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"st3\">\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Although surgery remains the cornerstone in symptomatic or deforming cases, recurrence and complications often require repeated interventions. Our findings emphasize the need for individualized, multidisciplinary management strategies, long-term follow-up, and the incorporation of evolving surgical and medical therapies to optimize outcomes and quality of life in patients with CFD.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.25259\/sni_942_2025","type":"journal-article","created":{"date-parts":[[2026,2,13]],"date-time":"2026-02-13T12:28:52Z","timestamp":1770985732000},"page":"81","update-policy":"https:\/\/doi.org\/10.25259\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Craniofacial fibrous dysplasia: Molecular insights, long-term institutional experience, and evolving surgical strategies"],"prefix":"10.25259","volume":"17","author":[{"given":"Gervith","family":"Reyes Soto","sequence":"first","affiliation":[{"name":"Department of Head and Neck, Unidad de Neurociencias, Instituto Nacional de Cancerolog\u00eda, Mexico City, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carlos","family":"Castillo-Rangel","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Hospital Regional \u201c1\u00ba de Octubre\u201d ISSSTE, Mexico City, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Danil","family":"Nurmukhametov","sequence":"additional","affiliation":[{"name":"Department of Medicine, I.M. Sechenov First Moscow State Medical University, Medical Sechenov Pre-university, Moscow, Russian Federation"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Manuel Encarnacion","family":"Ramirez","sequence":"additional","affiliation":[{"name":"Department of Human Anatomy and Histology, Institute of Clinical Medicine named after N. V. Sklifosovskiy, Moscow, Russian Federation"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bosco Emanuel","family":"Lazo Poveda","sequence":"additional","affiliation":[{"name":"Department of Head and Neck, Unidad de Neurociencias, Instituto Nacional de Cancerolog\u00eda, Mexico City, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Juan Carlos","family":"Garc\u00eda Aquino","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, ISSSTE Regional Puebla, Mexico City, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francisco de Jes\u00fas","family":"Garc\u00eda-Mendoza","sequence":"additional","affiliation":[{"name":"Central Research Laboratory, Faculty of Medicine, Benem\u00e9rita Universidad Aut\u00f3noma de Puebla Puebla, Mexico City, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Harvey Misael","family":"Aguilar Mora","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Hospital Ju\u00e1rez de M\u00e9xico, Mexico City, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"10894","published-online":{"date-parts":[[2026,2,13]]},"reference":[{"key":"10.25259\/SNI_942_2025\/ref-1","doi-asserted-by":"crossref","first-page":"467","DOI":"10.1016\/j.jfo.2019.10.012","article-title":"Fibrous dysplasia of the orbital region: Series of 12 cases and review of the literature","volume":"43","author":"Bertin","year":"2020","journal-title":"J Fr Ophtalmol"},{"key":"10.25259\/SNI_942_2025\/ref-2","doi-asserted-by":"crossref","first-page":"1103","DOI":"10.1007\/s11154-023-09832-2","article-title":"Efficacy of antiresorptive agents in fibrous dysplasia and McCune Albright syndrome, a systematic review and meta-analysis","volume":"24","author":"Bertin","year":"2023","journal-title":"Rev Endocr Metab Disord"},{"key":"10.25259\/SNI_942_2025\/ref-3","doi-asserted-by":"crossref","first-page":"2888","DOI":"10.3390\/diagnostics13182888","article-title":"Cell-free miRNAs as non-invasive biomarkers in brain tumors","volume":"13","author":"Beylerli","year":"2023","journal-title":"Diagnostics (Basel)"},{"key":"10.25259\/SNI_942_2025\/ref-4","doi-asserted-by":"crossref","first-page":"1833","DOI":"10.1097\/PRS.0000000000002151","article-title":"Surgical management of polyostotic craniofacial fibrous dysplasia: Long-term outcomes and predictors for postoperative regrowth","volume":"137","author":"Boyce","year":"2016","journal-title":"Plast Reconstr Surg"},{"key":"10.25259\/SNI_942_2025\/ref-5","doi-asserted-by":"crossref","first-page":"379","DOI":"10.1016\/j.coms.2024.03.004","article-title":"Craniomaxillofacial fibro-osseous lesions in children","volume":"36","author":"Burke","year":"2024","journal-title":"Oral Maxillofac Surg Clin North Am"},{"key":"10.25259\/SNI_942_2025\/ref-6","doi-asserted-by":"crossref","first-page":"766","DOI":"10.1056\/NEJMc2214862","article-title":"Safety and efficacy of denosumab for fibrous dysplasia of bone","volume":"388","author":"de Castro","year":"2023","journal-title":"N Engl J Med"},{"key":"10.25259\/SNI_942_2025\/ref-7","doi-asserted-by":"crossref","first-page":"459","DOI":"10.1097\/00000658-198510000-00007","article-title":"The surgical treatment of fibrous dysplasia. With emphasis on recent contributions from cranio-maxillo-facial surgery","volume":"202","author":"Edgerton","year":"1985","journal-title":"Ann Surg"},{"key":"10.25259\/SNI_942_2025\/ref-8","doi-asserted-by":"crossref","first-page":"e719","DOI":"10.1097\/SCS.0000000000003033","article-title":"Orbitocranial fibrous dysplasia: outcome of radical resection and immediate reconstruction with titanium mesh and pericranial flap","volume":"27","author":"Fadle","year":"2016","journal-title":"J Craniofac Surg"},{"key":"10.25259\/SNI_942_2025\/ref-9","doi-asserted-by":"crossref","first-page":"534","DOI":"10.1016\/j.ncrna.2023.07.002","article-title":"MiRNAs and lncRNAs in the regulation of innate immune signaling","volume":"8","author":"Gareev","year":"2023","journal-title":"Noncoding RNA Res"},{"key":"10.25259\/SNI_942_2025\/ref-10","doi-asserted-by":"crossref","first-page":"1356","DOI":"10.1016\/j.jcms.2015.06.043","article-title":"Primary and secondary reconstruction of complex craniofacial defects using polyetheretherketone custom-made implants","volume":"43","author":"Gerbino","year":"2015","journal-title":"J Craniomaxillofac Surg"},{"key":"10.25259\/SNI_942_2025\/ref-11","first-page":"799","article-title":"Radiological imaging findings of craniofacial fibrous dysplasia","volume":"30","author":"Gokce","year":"2020","journal-title":"Turk Neurosurg"},{"key":"10.25259\/SNI_942_2025\/ref-12","doi-asserted-by":"crossref","first-page":"60","DOI":"10.1097\/MED.0000000000000847","article-title":"Fibrous dysplasia in children and its management","volume":"31","author":"Gun","year":"2024","journal-title":"Curr Opin Endocrinol Diabetes Obes"},{"key":"10.25259\/SNI_942_2025\/ref-13","doi-asserted-by":"crossref","first-page":"346","DOI":"10.1007\/s00223-020-00780-6","article-title":"Increased prevalence of malignancies in fibrous dysplasia\/McCune-albright syndrome (FD\/MAS): Data from a national referral center and the dutch national pathology registry (PALGA)","volume":"108","author":"Hagelstein-Rotman","year":"2021","journal-title":"Calcif Tissue Int"},{"key":"10.25259\/SNI_942_2025\/ref-14","doi-asserted-by":"crossref","first-page":"15591","DOI":"10.3390\/ijms242115591","article-title":"A Rare skeletal disorder, fibrous dysplasia: A review of its pathogenesis and therapeutic prospects","volume":"24","author":"Kim","year":"2023","journal-title":"Int J Mol Sci"},{"key":"10.25259\/SNI_942_2025\/ref-15","doi-asserted-by":"crossref","first-page":"837","DOI":"10.1007\/s00256-020-03388-x","article-title":"Magnetic resonance imaging characteristics in patients with histopathologically proven fibrous dysplasia-a systematic review","volume":"49","author":"Kinnunen","year":"2020","journal-title":"Skeletal Radiol"},{"key":"10.25259\/SNI_942_2025\/ref-16","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1016\/j.crad.2014.06.022","article-title":"Maxillofacial fibro-osseous lesions","volume":"70","author":"MacDonald","year":"2015","journal-title":"Clin Radiol"},{"key":"10.25259\/SNI_942_2025\/ref-17","doi-asserted-by":"crossref","first-page":"439","DOI":"10.1186\/s13023-022-02588-z","article-title":"A multidisciplinary care pathway improves quality of life and reduces pain in patients with fibrous dysplasia\/McCune-Albright syndrome: A multicenter prospective observational study","volume":"17","author":"Meier","year":"2022","journal-title":"Orphanet J Rare Dis"},{"key":"10.25259\/SNI_942_2025\/ref-18","doi-asserted-by":"crossref","first-page":"e720","DOI":"10.1097\/SCS.0000000000002225","article-title":"Frontorbital fibrous dysplasia resection and reconstruction with custom polyetherlatone alloplast","volume":"26","author":"Nahumi","year":"2015","journal-title":"J Craniofac Surg"},{"key":"10.25259\/SNI_942_2025\/ref-19","doi-asserted-by":"crossref","first-page":"4100","DOI":"10.3390\/jcm12124100","article-title":"Fibrous dysplasia of the jaw: Advances in imaging and treatment","volume":"12","author":"Obermeier","year":"2023","journal-title":"J Clin Med"},{"key":"10.25259\/SNI_942_2025\/ref-20","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1097\/MOO.0000000000000955","article-title":"Benign bony lesions of paranasal sinuses and skull base: From osteoma to fibrous dysplasia","volume":"32","author":"Papargyriou","year":"2024","journal-title":"Curr Opin Otolaryngol Head Neck Surg"},{"key":"10.25259\/SNI_942_2025\/ref-21","first-page":"e48909","article-title":"Prognostic factors associated with overall survival in breast cancer patients with metastatic spinal disease","volume":"15","author":"Reyes Soto","year":"2023","journal-title":"Cureus"},{"key":"10.25259\/SNI_942_2025\/ref-22","doi-asserted-by":"crossref","first-page":"103","DOI":"10.25259\/SNI_1084_2024","article-title":"Anatomical insights and clinical implications of the persistent trigeminal artery: A cadaveric study utilizing latex injection techniques","volume":"16","author":"Reyes Sotos","year":"2025","journal-title":"Surg Neurol Int"},{"key":"10.25259\/SNI_942_2025\/ref-23","doi-asserted-by":"crossref","first-page":"122","DOI":"10.25259\/SNI_1016_2023","article-title":"Surgical treatment of orbital tumors in a single center: Analysis and results","volume":"15","author":"Reyes-Soto","year":"2024","journal-title":"Surg Neurol Int"},{"key":"10.25259\/SNI_942_2025\/ref-24","doi-asserted-by":"crossref","first-page":"117377","DOI":"10.1016\/j.bone.2024.117377","article-title":"Craniofacial fibrous dysplasia: A review of current literature","volume":"192","author":"Tuompo","year":"2025","journal-title":"Bone"},{"key":"10.25259\/SNI_942_2025\/ref-25","doi-asserted-by":"crossref","first-page":"653","DOI":"10.1097\/PRS.0b013e318196bbbe","article-title":"Craniomaxillofacial fibrous dysplasia: Conservative treatment or radical surgery? A retrospective study on 68 patients","volume":"123","author":"Valentini","year":"2009","journal-title":"Plast Reconstr Surg"},{"key":"10.25259\/SNI_942_2025\/ref-26","doi-asserted-by":"crossref","first-page":"570","DOI":"10.1055\/s-0039-3400292","article-title":"Fibrous dysplasia, Paget\u2019s disease of bone, and other uncommon sclerotic bone lesions of the craniofacial bones","volume":"24","author":"Van de Voorde","year":"2020","journal-title":"Semin Musculoskelet Radiol"},{"key":"10.25259\/SNI_942_2025\/ref-27","doi-asserted-by":"crossref","first-page":"1371","DOI":"10.1210\/clinem\/dgad657","article-title":"Management of RANKL-mediated disorders with denosumab in children and adolescents: A global expert guidance document","volume":"109","author":"Vanderniet","year":"2024","journal-title":"J Clin Endocrinol Metab"},{"key":"10.25259\/SNI_942_2025\/ref-28","doi-asserted-by":"crossref","first-page":"1857","DOI":"10.1002\/lary.30736","article-title":"Long-term outcomes following endoscopic transnasal surgery for optic neuropathy due to craniofacial fibrous dysplasia","volume":"133","author":"Wang","year":"2023","journal-title":"Laryngoscope"},{"key":"10.25259\/SNI_942_2025\/ref-29","doi-asserted-by":"crossref","first-page":"e1130","DOI":"10.1016\/j.wneu.2023.11.054","article-title":"Craniofacial fibrous dysplasia in fronto-orbital region: A single-center retrospective study of 38 cases","volume":"181","author":"Xu","year":"2024","journal-title":"World Neurosurg"},{"key":"10.25259\/SNI_942_2025\/ref-30","doi-asserted-by":"crossref","first-page":"1334","DOI":"10.1038\/s41379-022-01103-w","article-title":"GNAS mutation analysis assists in differentiating chronic diffuse sclerosing osteomyelitis from fibrous dysplasia in the jaw","volume":"35","author":"Xue","year":"2022","journal-title":"Mod Pathol"}],"container-title":["Surgical Neurology International"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/surgicalneurologyint.com\/craniofacial-fibrous-dysplasia-molecular-insights-long-term-institutional-experience-and-evolving-surgical-strategies\/","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/surgicalneurologyint.com\/surgicalint-articles\/craniofacial-fibrous-dysplasia-molecular-insights-long-term-institutional-experience-and-evolving-surgical-strategies\/","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,13]],"date-time":"2026-02-13T12:28:56Z","timestamp":1770985736000},"score":1,"resource":{"primary":{"URL":"http:\/\/surgicalneurologyint.com\/surgicalint-articles\/craniofacial-fibrous-dysplasia-molecular-insights-long-term-institutional-experience-and-evolving-surgical-strategies\/"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,13]]},"references-count":30,"alternative-id":["10.25259\/SNI_942_2025"],"URL":"https:\/\/doi.org\/10.25259\/sni_942_2025","relation":{},"ISSN":["2152-7806","2229-5097"],"issn-type":[{"value":"2152-7806","type":"electronic"},{"value":"2229-5097","type":"print"}],"subject":[],"published":{"date-parts":[[2026,2,13]]},"article-number":"81"}}